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British science accused in the wake of the MMR scare

I was originally going to blog this yesterday, but Dr. Oz’s offenses against science and medicine on his show that aired on Tuesday kind of pushed it out of the way. It’s not that I didn’t think the third part of Brian Deer’s expose of Andrew Wakefield’s fraud worthy of my attention. Rather, the Oz thing really got me peeved, peeved enough to push aside (temporarily, at least) Brian Deer’s deconstruction of how the editors of The Lancet scrambled to cover their proverbial asses, which they proceeded to do with alacrity, as the title of Deer’s article implies: The Lancet‘s two days to bury bad news.

I’ve been critical of The Lancet before for publishing Andrew Wakefield’s case series. Indeed, to this day, I hadn’t been able to figure out how Richard Horton, the editor of The Lancet, kept his job in the wake of l’affaire Wakefield, particularly after Wakefield’s massive conflicts of interest had been revealed in 2004, as well as the possibility that Wakefield had subjected vulnerable children to invasive procedures that were not medically indicated. The reason is not so much that I would expect peer review to have uncovered what we now know to have been blatant fraud. Peer review has a hard time doing that because the default assumption in science tends to be one of honesty, namely that what authors report in manuscripts submitted to journals does not represent falsified data. Oh, sure, editors and reviewers are fully aware that scientists will try to present their data in such a manner to put the best possible spin on their experiments, to make their story as persuasive as possible. That’s expected. What is not expected is outright dishonesty, falsification of data, the offense by Wakefield for which Deer presented strong evidence in his previous two articles.

No, what should have gotten Horton fired, from my perspective, is that he accepted such a poor manuscript. Even taken at face value and even if there had been no scientific fraud, Wakefield’s manuscript, a case series of only 12 children that, even viewed in as favorable a light as possible, didn’t support the hypothesis that MMR vaccination was somehow associated with a new syndrome consisting of regressive autism and enterocolitis. It was the thinnest of thin gruel, which, again, even if viewed in the best possible light, didn’t belong in the pages of The Lancet. Maybe in the pages of some bottom-feeding medical journal or another, but not in The Lancet. This is particularly true given the explosive nature of the implications of Wakefield’s paper, which should have resulted in more caution on the editors’ part to make sure that all the i’s were dotted and t’s crossed.

Of course, in most cases, the consequences of publishing such an article would be a temporary blot on the reputation of a journal, soon forgotten. Not in this case. In this case, the publication of Wakefield’s publication in The Lancet, coupled with Wakefield’s media whoring and the eager acquiescence of the British media, ignited a scare about the MMR vaccine that led parents to abandon the MMR in droves, driving the MMR uptake rate to levels below that necessary to maintain herd immunity. As a result, measles came roaring back in the U.K. such that it is now endemic again. Can Horton be directly blamed for this scare? Not exactly. But his irresponsibility did play a significant role in igniting the scare and at the same time permanently tarnishing the reputation of the journal for which he was responsible. In other words, he screwed up. He had no way of definitely knowing that his screwup would have such far-reaching consequences, although he should have had an inkling, but them’s the breaks. His screwup, instead of being quickly forgotten, leaving him to continue his career with minimal consequence, resulted in consequences that could not be ignored.

If I were in charge of The Lancet, I would have canned Horton’s ass in 2004 after Deer’s first set of revelations, or, if that were not possible (it’s not easy to fire a journal editor), I would have declined to renew his contract when it expired, assuming he has a contract.

Before I go on, though, I must point out one thing. After reading his installment, it is even more clear to me than it was a week ago when I blogged about it that Deer’s attack on Drs. Offit, Goldacre, and Fitzpatrick for supposedly being part of the “old boys network” of physicians downplaying Wakefield’s offenses and his investigative journalism was wildly off key in relationship to this most recent article, which criticizes British medical authorities and the Lancet for letting the Royal Free Hospital and the UCL investigate themselves and laments how medical authorities often don’t take fraud seriously enough. Neither of these are positions that Drs. Offit, Goldacre, or Fitzpatrick would be likely to disagree with in the least, and none of them that I’m aware of, other than Fitzpatrick, ever even criticized the bringing of charges against Wakefield before the GMC.

Deer is completely on key, however, when he describes what happened when the Wakefield situation blew up in 2004 after Brian Deer’s first set of revelations was published. In retrospect, it is not surprising (actually, it shouldn’t have been surprising at the time) that Horton had every motivation to try to minimize the damage to his journal and its reputation, and apparently that’s just what he did, as Deer points out as he describes what happened after his meeting with Horton and the editors of The Lancet in 2004, in which he laid out the evidence for Wakefield’s misconduct:

I had assumed that when I finished Horton would say that an investigation was needed to untangle these complex matters. There were at least three strands: possible research fraud, unethical treatment of vulnerable children, and Wakefield’s conflict of interest through the lawyer. But within 48 hours, and working with the paper’s three senior authors, the journal was to publish a 5000 word avalanche of denials, in statements, unretracted to this day.5 6 7 8 9

It can’t be emphasized enough that Wakefield took advantage of a vulnerable population (autistic children) in order to enrich himself. I mention it here again because it is a very important point.

During the GMC hearings, Horton claimed this:

“In this particular case,” he [Horton] told the GMC tribunal of three doctors and two lay members, seated to his right at the hearing, “we went to the vice-dean of the Royal Free, laid out the nature of the problem, and asked him to investigate and come back to us, as best he could, with his own judgment of the veracity or not of the allegations. In addition to that, we would look at the documentation as best we could and try and form our view as to whether those allegations were true.”

But what really happened was this:

But documents, emails, and replies obtained under the Freedom of Information Act reveal no formal investigation. What emerges is merely a scramble to discredit my claims during the 48 hours after I disclosed the information. They show the journal’s editor, the paper’s senior authors, and the Royal Free medical school, frantically mobilising against me. Were it not for the GMC case, which cost a rumoured £6m (€7m; $9m), the fraud by which Wakefield concocted fear of MMR would forever have been denied and covered up.

Deer then proceeds to describe exactly how this was done. Basically, there was no independent investigation. Right after Deer left Horton, Horton met with the three principal authors of The Lancet paper and devised a strategy wherein all impropriety was denied except for Wakefield’s conflict of interest in having accepted money from lawyers to develop evidence to support lawsuits against vaccine manufacturers, which they did their best to minimize as an offense as a failure on Wakefield’s part to disclose. Fortunately, that part appears to have backfired, as Horton’s concession that Wakefield had had a conflict of interest ignited a media firestorm:

His actions sparked a media firestorm. Although denying all of the most serious of my findings (now proved), he conceded that Wakefield had a conflict of interest–and that weekend was what journalists call “slow.”

The BBC was on the story within half an hour of the statements’ release. Independent Television News called Harris. And all of Fleet Street knew the thrust of an impending splash in the Sunday Times, the UK’s market leading Sunday broadsheet.

The furore blazed from Friday until Wednesday, and beyond.

Science is an enterprise that, because it is a human enterprise, can be corrupted when its practitioners do not possess the personal integrity to be honest in reporting their results. Andrew Wakefield is clearly just such a dishonest man, whose ambition and greed led him not only to accept money from lawyers to develop scientific “evidence” they could use in court while suing vaccine manufacturers, but then to falsify evidence for his case series, misrepresenting the clinical histories of several of the children, and then making plans to produce products based on his unsupported hypothesis that the MMR vaccine can cause autism associated with GI complaints, products that, according to Wakefield’s hopes, could make him many millions of dollars. Unfortunately, a combination of factors can provide motivation for such misconduct, including self-aggrandizement, becoming too enamored of one’s own ideas and insufficiently willing to give them up when they are not supported by the evidence, and just plain greed. While it’s obvious that Wakefield suffered from just plain greed, his ego almost certainly played a role.

It is also truly disheartening that, instead of taking the charges of fraud seriously, and trying to get at the heart of the matter, Richard Horton instead appears to have done his best at damage control. In this, he unfortunately follows a pattern that is all too common in science. An accompanying editorial by Douglas J. Opel, Douglas S. Diekema, and Edgar K. Marcuse, entitled Assuring research integrity in the wake of Wakefield addresses the question of how this can happen, be Wakefield and his misdeeds or other scientific fraud. They correctly point out that the problems that allow people like Wakefield to get away with what Wakefield got away with tends to be a systemic problem and that instances of fraud like Wakefield’s should be treated as adverse events. While this is a useful model as far as it goes, more useful is the concept that the culture of science needs to change:

We must transcend traditional hierarchies and authority gradients to empower everyone in the research enterprise–especially those on the front lines, such as research assistants, data analysts, and project managers–to raise questions and “stop the line.”12 We must train our research leaders–such as department chairs and medical school deans–to manage such inquiries. We must not allow it to be “customary” for journal editors “to discuss and take the word of those against whom the allegations are made.”3 Lastly, when allegations of research misconduct or unethical research are brought to the attention of research leadership, these leaders must recognise that they often have a conflict of interest in managing these allegations.

Most depressingly, it is very telling that it took Brian Deer’s investigation to bring the full extent of Wakefield’s fraud and scientific misconduct. In this case, scientists couldn’t keep an eye on their own house; it took an outsider to uncover the fraud. Science needs to do better. The consequences of not doing better are stark. Even though scientific research quickly refuted Andrew Wakefield’s claims with additional studies, science alone wasn’t enough to bury his fraudulent conclusions once and for all. I’m not even sure that Brian Deer’s revelations will be enough.

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]

176 replies on “British science accused in the wake of the MMR scare”

Peer review has a hard time doing that because the default assumption in science tends to be one of honesty, namely that what authors report in manuscripts submitted to journals does not represent falsified data. Oh, sure, editors and reviewers are fully aware that scientists will try to present their data in such a manner to put the best possible spin on their experiments, to make their story as persuasive as possible. That’s expected. What is not expected is outright dishonesty, falsification of data, the offense by Wakefield for which Deer presented strong evidence in his previous two articles.

Maybe it would be better if they, you know, actually looked at the data instead of the conclusions and the pedigree of the researchers.

“What is not expected is outright dishonesty, falsification of data, …..”

Why isn’t it? Because it’s assumed researchers abide by some kind of 19th century gentleman’s code? With the range of scandals in science that are building up, if scientists want to keep their reputations they’d better stop being so lazy. Publishing crap that you haven’t really reviewed is just as dishonest as producing it.

This kind of stuff is what legitimate science is undermined. Probably the most important science being done today, climate change science, has been damaged by association with this kind of stuff.

Maybe it would be better if they, you know, actually looked at the data instead of the conclusions and the pedigree of the researchers.

Clearly, you’ve never peer reviewed a scientific paper before.

Peer reviewers do look at the data. The problem is that falsified data can be very difficult to detect. In the case of a paper like Wakefield’s, without having access to the primary data, including all the subjects’ medical records, it’s basically impossible. Peer reviewers can’t spend that much time on a single paper, particularly since peer reviewing is one of those unpaid activities that academics are expected to do as part of their academic activities.

It took Brian Deer years of digging to uncover all of Wakefield’s offenses.

As for your crack about climate change science, it’s clear that you don’t know what you’re talking about there, either.

Orac, are you familiar with the Hauser scandal of last year?

In one case, according to an article in The Boston Globe on Tuesday, Gordon G. Gallup Jr. of the State University of New York at Albany asked Dr. Hauser for videotapes of an experiment in which cotton-topped tamarins were said to recognize themselves in a mirror. When he received the videotapes, Dr. Gallup could see no evidence that this was the case. Dr. Gallup did not return a call or respond to e-mail on Wednesday.

Dr. Hauser’s 2002 article in Cognition was published with two co-authors, but he has accepted responsibility for the error. One co-author, Gary Marcus of New York University, said he saw the summary of Dr. Hauser’s experiments but not the raw data. He was informed that there was a problem with the data, but has not seen the result of the investigation.

http://www.nytimes.com/2010/08/12/education/12harvard.html

Note: that was one of the co-authors!

Colleagues of Hauser’s at Harvard and other universities have been aware for some time that questions had been raised about some of his research, and they say they are troubled by the investigation and forthcoming retraction in Cognition.

“This retraction creates a quandary for those of us in the field about whether other results are to be trusted as well, especially since there are other papers currently being reconsidered by other journals as well,’’ Michael Tomasello, co-director of the Max Planck Institute for Evolutionary Anthropology in Leipzig, Germany, said in an e-mail. “If scientists can’t trust published papers, the whole process breaks down.’’

http://www.boston.com/news/local/massachusetts/articles/2010/08/10/author_on_leave_after_harvard_inquiry/

When that scandal was breaking I asked several researchers I know who review papers that are published in professional journals if they look at the data and none of them said they normally do. That practice is guaranteed to let through stuff that isn’t, based on the conclusions of the researchers, who may or may not let their interests influence those conclusions on the basis of professional status.

If, as you assert, the normal standards of peer review let through fraud and incompetence, then either there’s something wrong with peer review or with the concept that science is in the business of producing reliable information. I’d like science to be reliable a lot more than that a lot of stuff gets published. Your usual standard that something is “woo” if you don’t happen to like it doesn’t seem to be sufficient to guarantee reliability. Me, I’d like to at least know that the reviewers had looked at what they’re passing through.

Science scandals are as liable to damage the reputation of science as scandals in any other profession.

Since you’re excusing the present system, I’m surprised you’re in such high dudgeon at the results.

Lets suppose Wakefield’s paper was meticulously accurate in terms of its data (OK – it wasn’t, but just for the sake of argument…)

He would have been looking at a possible new phenomenon, which rightly would require explaining, and to generate a possibly plausible hypothesis for this is not necessarily a bad thing to do. In his eyes MMR seemed to be the likely culprit, and therefore this would merit further exploration and investigation. As scientists we should welcome challenges to the prevailing consensus or opportunities to explain new phenomena. So asking the Lancet to publish his paper was probably an OK thing to do.

Whether it should have been published is another matter – until now, I was of the opinion that the Lancet had published the paper in good faith and only later, to spare its blushes once the shit hit the fan, tried to explain matters away. But it seems that before the paper was published serious concerns about it were directly raised with them.

So how should Horton have acted at that point? I believe he should have deferred publication and asked for both an independent investigation into the Deer allegations, and also asked Wakefield to look more closely at his scientific evidence (Wakefield inserted an addendum at the end of the paper to say he had seen another 40 children with the syndrome) and come back with a more thorough analysis.

Of course we now know that of the other cases Wakefield’s unit had seen, precious few of them had parents who blamed the MMR vaccine (so they were useless for his purposes).

The raw data of papers should be, ideally, made publicly available, always — within reason (i.e. anonymized when appropriate.) I don’t see any reason why things shouldn’t work like this, with all the technology that’s available at the moment.

There should be journals that only accept papers if the authors make the raw data and source code available to the public. These journals would and should be considered more credible than the rest.

Beyond increased transparency, raw data can be re-analyzed by other data scientists, who can come up with new findings, and superior methods of data analysis. The data could be used in data mining/analysis competitions, and so forth. It would accelerate the scientific process.

Peer review has a hard time doing that because the default assumption in science tends to be one of honesty

Not just for fraud, as Orac states, but for other kinds of scientific misconduct such as plagiarism. Peer reviewers don’t have the time or the resources to reproduce the results ab initio; the system depends on the reviewer being able to assume (and most of the time this assumption is valid) that the authors of the manuscript performed the described experiment (or simulation or theoretical derivation, in some fields) and are reporting in good faith and in their own words the outcome of that experiment. Where fraud has been committed, it is usually detected after the fact, either by chance (as in the Jan Hendrik Schön case, where a junior scientist happened to notice that two figures purporting to show results from rather different experiments were in fact identical) or after a thorough investigation (as in the Wakefield case).

That’s not to say that peer review as actually practiced is perfect. I’ve seen too many instances of pro forma reviews and cases where the referee is flat-out wrong (both on my own papers and by the other referee on papers I have reviewed). I’ve also read too many papers where my immediate reaction was, “How the %&#@ did that get past the referees?” But these are weaknesses of implementation, not of peer review per se. A more serious flaw that I don’t have an immediate answer for is the perverse incentive effect: those of us who do our refereeing assignments on time and thoroughly tend to be rewarded with more refereeing assignments, while those who do a bad job suffer the penalty of fewer refereeing assignments (i.e., there are incentives for doing the job badly).

I recall that Mr. Deer has made statements in the past regarding problems with the Lancet paper arose with peer-reviewers prior to publication. Of course memory can be faulty so I hope Mr. Deer may be so kind as to correct me or reiterate.

A little OT, but in the business section of Tuesday’s NYTimes there is an article on the AAPS oppositon to the new health plan. It covered some of the stuff they have published, and one phrase that made me happy was a matter-of-fact comment that among their published studies is one “linking child vaccinations to autism, a discredited theory”.
The author of the article also asked the editor of their journal about peer review. ” When asked, he said he could not say that what percentage of those reviewers were members of his own organization.” Link below
http://www.nytimes.com/2011/01/19/business/19physicians.html

Most depressingly, it is very telling that it took Brian Deer’s investigation to bring the full extent of Wakefield’s fraud and scientific misconduct. In this case, scientists couldn’t keep an eye on their own house; it took an outsider to uncover the fraud.

But as you say, peer-review isn’t well equipped to detect this sort of thing. It isn’t really designed to – presumably this is one reason for the importance of independent replication. So perhaps it is unsurprising that it was turned up by a journalist rather than a scientist.

A little OT, but in the business section of Tuesday’s NYTimes there is an article on the AAPS oppositon to the new health plan. It covered some of the stuff they have published, and one phrase that made me happy was a matter-of-fact comment that among their published studies is one “linking child vaccinations to autism, a discredited theory”.
The author of the article also asked the editor of their journal about peer review. ” When asked, he said he could not say that what percentage of those reviewers were members of his own organization.” Link below
http://www.nytimes.com/2011/01/19/business/19physicians.html

Perhaps we can understand why the public will throw up their hands collectively and say, ” You can’t trust research!” And woo-meisters will jump at the chance to dismiss scientific journals entirely.

I once (informally) counselled someone- who had a son with an SMI- who opined, ” But science has been wrong before! Maybe they are wrong about his illness!” While I’m sure that it might be emotionally reassuring to think this way, I don’t think that it’s reasonable to assume that the general outlines of what we know will be suddenly overturned and that overnight the prognosis will be changed to “favorable”.

But *l’affaire* Wakefield reminds that progress often runs a crooked path** – it’s like looking at the history of the Dow- it’s gone *up* -despite many twists and turns and recessions along the way. People generally don’t have that broad historical perspective- be it history of the DJIA or of theories about mental illness or autism. A job for us.

** in his case, very crooked.

While certainly going off base in his reply, I think there is a grain of insight in Anthony McCarthy’s post at #1. During my post-grad research time my good friend and lab director devised this exercise where he had the undergrad research monkeys… err… assistants… read new studies that were released without knowing who the authors were or what journal it was published in. Removing all the credentials associated with a study made them much less forgiving in their analyses of the study and the veracity of the data. Suddenly papers in lower impact journals seemed to be pretty reasonable and papers in high impact journals with big name authors were seen as crap. With the pressure to “publish or die” many studies are being pushed through on prior credibility when they lack in data and insight.

Changing the culture of “publish or die” and throwing in an arm of the peer review in which reviewers are unaware of the author or the journal in question could help decrease the overall number of publishings a year and simultaneously increase the quality of our body of published data.

Assume that uncorroborated case reports or case series are manifestations of spurious correlation, delusion, misunderstanding, error, motivated reasoning, or fraud. This will save everyone a lot of detective work and expense, which is better directed toward more science.

During my post-grad research time my good friend and lab director devised this exercise where he had the undergrad research monkeys… err… assistants… read new studies that were released without knowing who the authors were or what journal it was published in. Removing all the credentials associated with a study made them much less forgiving in their analyses of the study and the veracity of the data. Suddenly papers in lower impact journals seemed to be pretty reasonable and papers in high impact journals with big name authors were seen as crap.

I’ve actually discussed this issue before; I don’t have time to look up the link right now. If memory serves, I discussed the issue of double blind reviewing, where neither the authors nor the reviewers know who is who. There are problems with this concept, but I did like the idea of stripping manuscripts of author names. One problem with this concept is that a lot of areas are relatively small fields, and anyone who knows a lot about a topic will often find it pretty easy to figure out who the authors are based on what they are studying, the references they cite, and the hypotheses their work supports.

As for Mr. McCarthy, he seems to think that I’ve never written about scientific fraud before, when in fact I have written about it on several occasions. I don’t think that anyone can fairly describe me as “defending” the current system, at least not in the way McCarthy insinuated. (His mention of climate change science was particularly off-base, if he thinks that was an example of scientific fraud. It wasn’t.)

I was merely pointing out that peer review can’t examine all the raw data for most studies because it is impractical, given the massive time commitment that it would require. In his discussion of the Hauser case, he seems to be willfully conflating the concept of co-authorship (where not being aware of the raw data, at least all of the raw data related to your part of the study, is indeed not acceptable) and scientific peer review (where it is usually impractical to look over every blot, every bit of raw data, etc.).

My acid test for someone criticizing the peer review system is to ask them what concrete proposals they have to improve it. Double blind peer review is one such proposal, and it is a serious one. Some go to the other extreme and propose completely open peer review, in which the peer reviewers sign the manuscript and their names are listed somewhere in the acknowledgments or in a separate line after the authors. The idea behind this latter proposal is to force peer reviewers to put their names and reputations on the line as well. Similarly, proposals to make all raw data available are not unreasonable, but might well have unintended consequences, such as patients being reluctant to enroll in clinical trials because they believe that they might somehow be identified. (I know anonymization of the data is part and parcel of such proposals, but patients, particularly underserved populations who could most benefit from increased access to clinical trials, are suspicious enough that doctors are doing “Tuskegee” trials already, and such assurances do not usually convince them.) Even so, this might be the best option.

We’ll see if Mr. McCarthy has any concrete suggestions for how to improve the situation that are actually workable.

I’m (sort of) with @titmouse. I think ultimately the solution is not to make peer review better able to detect fraud, because that is very difficult to impossible, but to try to somehow get the message out that one small study of ANYTHING is really meaningless except as a possible kicking off point for more studies. It doesn’t really matter from a scientific perspective that Wakefield was fraudulent rather than just wrong. It was a study with twelve subjects and the results were never replicated. End of story.

@ Elizabeth Reid

In the light of your remarks, if I thought you were a research scientist in a significant area of public interest, I would pull all your papers.

Why would somebody shrug off research fraud? Why would somebody say that Wakefield’s ability to place fraudulent findings on a matter of child health into the Lancet, and keep it there for six years in the face of all the public and professional scrutiny that it received, “doesn’t really matter from a scientific perspective”?

I find your attitude just beggars belief. If you think so lightly of research integrity, believing that armchair reading is sufficient to protect the public, then I would really have to wonder what goes on in your professional world. I really would.

@Brian Deer — this is pretty much what got your knickers in a twist over Offit, as well, isn’t it?

Try to understand — as was pointed out on the other thread, from a scientific perspective, someone might have committed fraud, but might still be correct about his hypothesis. It is unlikely, but it is remotely possible. In order to dismiss the researcher himself from any position of future responsibility, it is necessary to prove fraud. In order to dismiss the hypothesis from any further scientific consideration, it isn’t necesarilly that one has to prove that the researcher committed fraud, because as I said, it is remotely possible that despite the fraud the idea itself could be correct; to ditch the idea from further consideration in science, the hypothesis has to be demonstrated to be wrong.

What part of this perspective, exactly, do you have such a problem accepting? Why exactly?

Maybe in the pages of some bottom-feeding medical journal or another, but not in The Lancet. This is particularly true given the explosive nature of the implications of Wakefield’s paper, which should have resulted in more caution on the editors’ part to make sure that all the i’s were dotted and t’s crossed.

It’s part of an interesting discussion on Sandwalk I referred to some time ago that it is in fact exactly the case that, paradoxically, it can be those papers making the most spectacular (short of outrageous) claims that may receive the least critical examination.

Consider if you are an editor of a journal and reviewers of a paper. The paper is going to make a real splash, earning publicity for the editor and his journal, as well as generating publicity and excitement (research funding?) in the reviewers’ field of endeavor. These are, it seems to me, incentives to get this thing published and to see nagging doubts as minor.

Now consider the editor and reviewers of an extremely well-researched paper confirming prior work in the field. No such positive motivation; in fact the paper, no matter how well-researched, may not even get published.

I think (I hope!) that you have profoundly misunderstood me, but maybe not. Luckily for me I am not a research scientist so I don’t have to be worried that you’re calling my institution right now. (Seriously? You’d be pulling all of my papers because of a blog comment? I’m glad you’re so dedicated – and I don’t mean that one bit sarcastically, your work is awesome and I really admire it – but that seems extreme.)

Of course it matters that Wakefield is fraudulent. I just don’t think that the integrity of the peer review and publication system can ever rest on fraud detection as a major pillar, because it’s just not set up to do that. NO ONE should be making major decisions based on one study of twelve subjects, even if the researcher is assumed to be honest and the journal is The Lancet and so on. It just isn’t remotely enough evidence to do that, and I really wish that that could get communicated to the general public. That way we would be better protected both from deliberate fraud such as Wakefield’s, honest mistakes, and initial results that don’t hold up, all at the same time.

I think what I’m saying is that I make a distinction between, paraphrasing your words, “being able to place a fraudulent paper in the first place” and “being able to keep it there in the face of evidence that it was fraudulent”. Obviously, the factors that let him keep it there despite growing evidence that it was fraudulent need serious scrutiny and (figurative) heads on blocks, but I think the system that let him place it there in the first place worked as well as one could expect. It was a study of twelve subjects. No one could replicate it. That should be that.

Oops, sorry, in my last comment the italics tag was only supposed to apply to “The Lancet”.

@ Luna the cat,

So, leaving aside your snobby “try to understand” advice, is it that it “doesn’t really matter” then that somebody fabricates research which shows vaccines to be safe and effective because, well, they are?

From a scientific point of view, of course.

Hah! I have been called a “snob” by Brian Deer, I’m sure that qualifies me for some sort of distinction! ;-D

@Brian Deer,

Please don’t misunderstand, I’m not trying to downplay your work uncovering the fraud; as with many people here, I admire it immensely and often refer people to the results. But in response to your question: if someone fabricated data that purported to prove that vaccines were safe and effective, what that would mean is that someone else better go and do a *real* test of vaccine safety and efficacy, toot sweet. And the replicated experiments would be what either validated or disproved the idea — the fact that the first study was fraud means that THAT study can’t be taken seriously — it doesn’t mean that the idea behind it is wrong, it just doesn’t mean the idea can’t be assumed in any way to be right. It is the further scientific work which makes that determination.

When I asked my question, what part of this do you have such trouble with, and why, I meant that seriously. It was a question, not a snark; I’d be delighted if you would go into it a bit more, since I’m having trouble understanding your stance at the moment.

I haven’t read anywhere near all of what McCarthy has to say about this, but right away I was highly disturbed that he thinks that problem of fraud can be ameliorated by getting rid of the default presumption of honesty in data. Sounds nice, but just exactly how do you propose going about doing that? The reason data falsification is so hard to detect is not just because scientists usually assume it isn’t happening; it’s that most of the time there is no direct way to even check on it — and even when there is, it’s insanely cost prohibitive to expect that peer reviewers would check on this for every single paper.

As a trivial example, if a researcher is using a piece of equipment to measure something, how do you know that what she wrote down as the measurement is actually what the readout on the screen said? Should there be a videotape of every measurement made, and then the peer reviewers watch all of the tape? Please.

I realize that’s an unrealistic example, that data falsification doesn’t in practice work like that, but I think it illustrates my point. The data is the record. You can’t have a record of the record — or, I suppose you could, but that could be falsified too, all the way back to, as I said, videoing every action the researchers take. Yeah right.

As I understand it, most falsification of data is detected because the falsifier screws up — either he presents data that is just too “neat” to be believe, or in one high profile case I can’t recall, uses the same cooked data set for two different papers saying it came from separate experiments… stuff like that. There would be virtually no way to have detected that kind of thing, because the thing that was being fabricated was the record that you would check to see if there was fabrication going on.

The default presumption of honesty (at least in presenting the data) is unavoidable. Which is not to say that nothing can be done about fraud, but pretending it’s as easy as just checking the data is silly.

There is a huge difference between mis-interpretation of data & lying about data. Wakefield lied – he made the data fit the conclusion that he had already reached (because he was paid a hell of a lot of money get the results the lawyers needed).

I don’t know how Wakefield managed to skate along for so long – perhaps because the whole topic became political/social almost immediately.

We do need to continue to find better ways to check work & replicate results before studies are accepted as “fact.”

Ironically, I’m spoken to researchers in the Pharma industry that see drugs and treatments abandoned even very late in the process, after millions of dollars had been spent, because the results weren’t what was expected. They didn’t fudge the numbers – they accepted the fact that they were wrong & moved on. Wakefield could have done that, but instead, he made the results fit his conclusions – and that’s fraud.

I am aware that you have blogged on the topic before (and quite well, I may add) and that you have offered some concrete ideas for revision and betterment of peer review. I also agree that the commentary about AGW science was completely off base as well. I wanted to take the glimmer of a point made and offer a real world example of a (at least partial) solution to the issue.

I understand and agree that in many fields the pool of experts is narrow enough to be able to deduce who is authoring the article under review. The system can never be “perfect” but it seems to me these are concrete ways to improve it. Your idea about having the reviewers be identifiable and thus accountable for their reviews can further enhance the intellectual honesty. I think that both ideas can be implemented together – and perhaps a system wherein the reviewers’ identities can be held secret (but ultimately available in certain circumstances) should the paper be denied and left open for those accepted (to uphold the level of accountability) can be implemented.

As for Mr. Deer, I personally (and I think most here as well) think very highly of your work and I see little reason to harbor doubt as to your integrity and skill as a journalist. Your work in thoroughly discrediting Wakefield as fraudulent I believe was very important for a number of reasons (which have been outlined by Orac and others in the comments as well). It seems to me an idealized notion that the science should settle it out and Wakefield’s fraud is non-important – and I think that even Offit or Goldacre don’t really think that. They merely make the point that the study itself was so bad it never should have held the weight that it did. Exposing the fraud was a necessary step to demonstrate to the general populace that he and his work should be ignored, discarded, and blighted but for scientific circles it was superfluous. In fact, I had a friend of mine who is a lay person with interest in this send me an email of your work before I had found it myself (I was on holiday and not keeping up). When she mentioned it and asked what I thought my first response was “Oh, well his stuff has been discredited for ages and there is no credulity to anything he has said. Nothing is new.” As I’ve come to realize (and Orac as well) there is something new – from a popular opinion standpoint and from a self-regulation standpoint. As I see it, from a scientific perspective, you have brought to us evidence that we actually need to change and improve our process, have better self-regulation, and more intellectual honesty. Your work has done nothing to change what we have thought about the ramifications of Wakefield’s work from a [I]scientific[I] standpoint – but much very important work from a public opinion standpoint.

Changing the culture of “publish or die” and throwing in an arm of the peer review in which reviewers are unaware of the author or the journal in question could help decrease the overall number of publishings a year and simultaneously increase the quality of our body of published data.

Actually the standard today is that peer review is “blind.” We do know the journal — you have to, because you have to know whether the paper is suitable for the journal — but not the authors. So that’s not really the issue. (Yeah, sometimes you can guess.)

Your work has done nothing to change what we have thought about the ramifications of Wakefield’s work from a scientific standpoint

Oh, I dunno – I think there is an argument to be made that even speaking in terms of “pure” science, whatever that is, there is a distinction between garbage work and fraudulent work.

The thought is interesting to me that Wakefield’s “study” may have been as small as it was (and would have been unimpressive but for the subject matter) because something larger could have been subjected to statistical analysis that may have indicated fraud, not just bad work, since they would have different statistical “signatures” (e.g., as Deer found through investigation, all the errors pointed in one direction).

@cervantes — not all reviewing has author names removed. It depends entirely on the journal.

Brian: You’re conflating two issues in arguing with the commenters (and Offit et al.).

The fact that the study consisted of a handpicked case-study group with no randomization or replication, and subsequent studies found no evidence of an MMR-autism link, is enough to disregard it scientifically even if it wasn’t fraudulent. This is the point Offit and Elizabeth are making.

That it was also fraudulent is why Wakefield should be barred from any kind of medical or scientific practice and no one should trust anything he says. It’s not irrelevant, because Wakefield is still around and (somehow) carries credibility among non-scientific people, but it has little bearing on a paper that was discredited already.

dt @ 4:

I believe that Brian Deer’s investigations into the matter began some years after the publication of Wakefield’s paper (which happened in 1998).

Not to say there weren’t questions raised by reviewers when the paper was being reviewed, of course. Only that Horton & Deer’s discussions would have occured after publication.

If I am incorrect, I trust I will be put right.

For small fields, blinding of authors could be problematic. For example, the big international symposium for my specialization will attract maybe 50 or 60 people from only a few labs. You can pretty much guess which lab produced a manuscript by the study subject and, in ecological studies, the geographic location.

@jud#29: What I am talking about (and I believe the distinction being drawn by the likes of Orac, Offit, et al) is that we in the medical sciences have long ago realized that the science behind the study, and thus the hypothesis posited, were invalid. The distinction becomes important when you think about subsequent studies and clinical recommendations – regardless of the fraud there was no change in clinical recommendations, no change in scientific consensus regarding MMR. We did not need to know of Wakefield’s fraud to feel good about the fact that we did not (as a whole) buy into and change our application of clinical medicine. From the scientific standpoint it was like finding out an inmate on death row was actually guilty of 6 murders instead of 5. Yes, from a political and personal standpoint that data is relevant. But the person is already on death row, convicted, and over with – the legal system did not need that extra bit of information to justify the action.

Wakefield’s study should have held no merit or sway whatsoever. Period. The science was easy enough to know that. Deer’s discovery and proof of fraud relates ONLY to the political and social fallout and the flaws in the process and media coverage of the “study.” It does not relate to or change the impact of the science behind the study. That was crap from the get go.

Elizabeth Reid (#17) comments:

“It doesn’t really matter from a scientific perspective that Wakefield was fraudulent rather than just wrong.”

to which Brian Deer (#18) retorts:

“Why would somebody shrug off research fraud? Why would somebody say that Wakefield’s ability to place fraudulent findings on a matter of child health into the Lancet, and keep it there for six years in the face of all the public and professional scrutiny that it received, “doesn’t really matter from a scientific perspective”?”

As I see it, there are two “non-overlapping magisteria” here: one is the realm of scientific validity or “truth”, if you like; the other is the realm of ethics.

In terms of validity or “truth”, Wakefield’s 1998 Lancet paper was known to be invalid (i.e. attempts to replicate his findings failed to show what he claimed) long before his data were shown to be fraudulent. His pathetic attempts to “vindicate” his research by claiming conspiracy and corruption on the part of his critics were laughed off by the “scientific community” because that’s exactly the wrong way to deal with scientific criticism. To many of us, his claims of persecution only showed that he had no faith in his results and was trying to “save face”.

As Mr. Deer pointed out in his articles, Dr. Wakefield was offered the time and resources to replicate his findings in a larger group of subjects, but he declined to do so. Had this been more widely known, it would have immediately raised suspicion of fraud in the “scientific community”. He was refusing to do what he should do to defend his findings and – as we only later found out – was not able to plead a lack of time or resources to do it. This would have been (and is) highly suggestive of conscious fraud.

In the ethical realm, I believe that any scientist would be appalled that Dr. Wakefield (or any scientist) deliberately falsified data. I can’t believe there would be a single exception. The only reason that science “works” is because we implicitly trust that researchers won’t commit fraud. We expect them to be wrong on occasion, but we expect that the errors and misinterpretations of data will be honest mistakes, not deliberate attempts to deceive. Being wrong doesn’t end a scientific career (unless you’re usually wrong), but a single act of fraud will bring a scientific career – even a long and productive one – to an immediate end.

Although I cannot speak for anyone but myself, I think that it’s probable that most scientists – at least, those who knew anything about Andy Wakefield prior to last week – considered Wakefield’s research a “dead issue” (and dead wrong) long ago. Thus, the recent revelations of fraud only serve to explain why his conclusions were wrong.

From a purely scientific perspective – from the perspective of increasing human knowledge about how the Universe works – Andy Wakefield’s work was dead long before we knew it was fraudulent. It isn’t any less scientifically relevant today than it was last year, since the “relevance scale” only goes down to zero.

Prometheus

Prometheus – you have said what I attempted to much more eloquently. Thank you kindly. I always find your comments well worded. I have been trying to participate in this conversation through a sinus infection and bronchitis whilst packing to catch my flight to Australia tonight.

Thanks, Midnight Rambler (31) and Prometheus (35), you have explained what I was trying to get at much more eloquently than I could. Of course I’m appalled that Wakefield falsified data (and honestly far more appalled that he performed invasive medical procedures on children for no reason, I would be far less bothered by the situation if he’d been falsifying data about the Higgs bosun). But the whole system of peer review and publication is set up explicitly not to be about the credibility of the researcher but about the soundness of the work. It works imperfectly, but it did work in this case, by showing these results were meaningless well before they were shown to be fraudulent. Unfortunately, by then the idea had gotten into the public imagination.

Brian Deer@18:

Please consider that there are multiple valid concerns at issue in L’Affaire Wakefield. An analogy might help:

I am an emergency medic. My friend is a police officer. Leaving a football game, we come upon a scene where a fan of one team is beating the stuffing from a fan of the opposing team [1].

My friend’s priority is apprehending the assailant. Mine is stabilizing the victim.

I can understand your prioritizing the need to deal with the assailant. Please do us the courtesy of respecting our attention to the victim.

[1] This may be a uniquely American thing. Please try to stretch your imagination.

@D.C. — your analogy is extremely British as well. The only thing that differs is what we call “football”. 🙂

I like your analogy, btw.

“No, what should have gotten Horton fired, from my perspective, is that he accepted such a poor manuscript. Even taken at face value and even if there had been no scientific fraud, Wakefield’s manuscript, a case series of only 12 children that, even viewed in as favorable a light as possible, didn’t support the hypothesis that MMR vaccination was somehow associated with a new syndrome consisting of regressive autism and enterocolitis.

Any good scientist would agree, again, a study with more authors than subjects should have been a letter to the editor and not a major journal article. The Lancet did their job poorly and now BMJ’s hit man is crying “fraud.” I doubt that Wakefield committed fraud and certainly don’t believe the biased reportage of a writer out to get Wakefield. They both have exaggerated and we now get to choose which of the two has good intentions and which has a vendetta. I choose . . . Dr. W. for the former and Deer for the latter. Anyone here agree?

Best,

Jay

@Dr. Jay

It’s a good thing that Deer provided lots of citations and evidence to support his accusations, then. Perhaps you might try, y’know, reading them? But that might make you question your hero worship respect for Wakefield, and we can’t have that, no no. After all, if Jenny support him, you have to, too, no?

@ Dr. J

Umm, no. Fraud was unquestionably committed by Wankers. Whether Deer has a vendetta or not, I could not care less. He has uncovered fraud. Perhaps Deer is a bit miffed that it took so damn long for anyone of the responsible authorities (Lancet, medical community, RFH…) to do anything about it.

No.

Wakefield’s “intention” was pretty patently to line his own pockets from the start. And Deer did outstanding work at uncovering a fraud which was most certainly of great public interest.

Personally, I was convinced that Wakefield had committed deliberate fraud before I knew that he had misrepresented patient’s medical data — I figured that since I read the testimony about the Unigenetics lab PCR, and what was done. But Deer uncovered a lot more, and it is in the public interest that he did so.

You are in serious denial, Jay. It takes a big man to admit that he has made a mistake — and patently, you aren’t that big.

Consider if you are an editor of a journal and reviewers of a paper. The paper is going to make a real splash, earning publicity for the editor and his journal, as well as generating publicity and excitement (research funding?) in the reviewers’ field of endeavor. These are, it seems to me, incentives to get this thing published and to see nagging doubts as minor.

I agree, and a corollary of this statement is that journals higher up the food chain are more likely to encounter such papers. The GlamourMags are notorious for publishing splashy papers which ultimately do not stand the test of time. Schön, whom I mentioned in my earlier post, was especially adept at writing papers for the GlamourMags, and the majority of his retracted papers were published there. Being outside the field of medicine, I’m not completely sure of the pecking order, but my understanding is that The Lancet is (or at least was, prior to the Wakefield affair) one of the top medical journals, part of the tier just below the GlamourMags, and therefore susceptible to this phenomenon. I certainly have seen this phenomenon in play at Physical Review Letters, which has a comparable stature in my field: PRL has published some papers which, as subsequent work showed, turned out to be cases where the authors were fooling themselves (though, oddly, none of Schön’s retracted papers were published in PRL).

There is a difference between fooling yourself and committing fraud. One is honest error, and the other is not. But they have some properties in common, among which is that subsequent researchers will fail to duplicate the results. One would have to investigate, as Mr. Deer has done here, to distinguish the two cases.

I doubt that Wakefield committed fraud and certainly don’t believe the biased reportage of a writer out to get Wakefield. They both have exaggerated and we now get to choose which of the two has good intentions and which has a vendetta.

Fortunately, we don’t have to guess. We can look at facts. So how about you explain why all the facts Deer discovered DON’T prove beyond any shadow of a doubt that Wakefield was in it purely for profit? And manufactured data, lied, and harmed children in pursuit of that?

My friend’s priority is apprehending the assailant. Mine is stabilizing the victim.

I can understand your prioritizing the need to deal with the assailant. Please do us the courtesy of respecting our attention to the victim.

Exactly. I was about to write a long response to Mr. Deer’s slam against Elizabeth, but Prometheus (@35) and you nailed it better than I could think of a way to do.

And now, as much as I hate to have to write this…I must.

Mr. Deer, accusing some of my readers who pointed out that, from a strictly scientific point of view, whether or not Wakefield committed fraud is less important than that he was wrong of either dismissing fraud as unimportant or somehow not caring about the truth is counterproductive and misinterprets what they mean. It really is and does. This is especially true, given that, other than the anti-vaxers and other advocates of quackery and pseudoscience who show up from time to time in my comments to howl their outrage, the vast majority of my readers are great admirers of your work in exposing Andrew Wakefield’s perfidy. So am I. However, my admiration for your dedication and tenacity and wanting to understand your frustration at the abuse you’ve taken over the years because of your work exposing Wakefield will not stop me from telling you when I think you’ve gone too far.

And, make no mistake about it, I really do think that you went too far in your remarks to Elizabeth (@18), particularly the bit about how, if she were “a research scientist in a significant area of public interest” that you would “pull all her papers.” That was completely uncalled for, and I think owe Elizabeth an apology for that remark alone.

If my saying these things means your ire will now be directed at me, so be it. But please consider: These people whom you are criticizing are your allies and fans. They (and I) also agree with you about far more than we disagree about. Can’t we be civil in our disagreements? I understand that you think scientists have downplayed the importance of your work, but, as I said before, I really do think the misunderstanding is primarily a result of two very different ways of looking at the world and not because scientists somehow think your work is without value. I refer readers again to my post from last week for the details:

https://www.respectfulinsolence.com/2011/01/misdirected_criticism_by_someone_from_wh.php

Any good scientist would agree, again, a study with more authors than subjects should have been a letter to the editor and not a major journal article. The Lancet did their job poorly and now BMJ’s hit man is crying “fraud.” I doubt that Wakefield committed fraud and certainly don’t believe the biased reportage of a writer out to get Wakefield. They both have exaggerated and we now get to choose which of the two has good intentions and which has a vendetta. I choose . . . Dr. W. for the former and Deer for the latter. Anyone here agree?

Dr. Jay. You keep saying you don’t believe Brian Deer. My recent remonstration with him notwithstanding over going a bit too far in criticizing a couple of my readers, I still admire the detail with which Deer has documented each and every one of his conclusions and believe the results of his investigation. Why do I believe them? Because he’s produced the goods. He’s documented everything he’s concluded in agonizing detail.

In comparison, Dr. Jay, all you do is to float in here from time to time, whine about how you think Deer has a vendetta and blithely dismiss his years of work by saying “I don’t believe Deer.” You present no evidence. You present no arguments other than sticking your fingers in your ears and chanting, like a child, “La la la la I can’t hear you!”

Let’s just put it this way. You would be taken a lot more seriously if you were able to produce–oh, you know–some actual evidence for your assertions or if you were able to produce–oh, you know–evidence of actual errors or deficiencies in Deer’s reporting. You can’t, and whenever I call you out on your lack of evidence or valid criticisms, you disappear again for a while, only to reappear later spouting exactly the same nonsense.

Pathetic. Again.

@Jay Gordon:

BMJ’s hit man is crying “fraud.”

So Deer is BMJ’s “hit man”? Meaning the BMJ has it out for Wakefield? What evidence do you have that the BMJ has it out for Wakefield. Besides the fact they accused him of fraud. Unless, of course, the mere accusation of fraud means they must have it out for him.

I doubt that Wakefield committed fraud

Why? Do you know him personally, and he just doesn’t seem like the type of person to do that?

… and certainly don’t believe the biased reportage of a writer out to get Wakefield.

What about it is biased? Or is it that since (according to you) Deer has it out for Wakefield that his reporting must be biased, and hence you don’t even have to bother reading it?

What type of reporter would Dr. Jay not think was biased? One that investigates Wakefield and finds he did not do these fraudulent things? In what way he is biased other than after doing years of research about Wakefield he finds him guilty of many things?

Brian Deer’s reaction to Elizabeth might have been uncalled for, but I think Elizabeth is still wrong.

What if Wakefield’s study had been a huge study (1000s of subjects) with falsified data? From a scientific perspective, a fraudulent study is not the same as an unreproduced study. To clarify, suppose the study met inclusion criteria in a meta-study.

So it’s not just an ethical vs. scientific consideration, as Prometheus argues. If the Bad Guys manage to produce more papers than the Good Guys, a statistical problem results that could, in principle, render science useless. So Brian Deer’s service to the public interest is essential, should not be dismissed, and others like him should be encouraged.

@D.C. — your analogy is extremely British as well. The only thing that differs is what we call “football”. 🙂

Really? So what do you call that game where two teams run around continuously kicking (well, usually) a round black-and-white ball trying to get it into the goal that the other team is defending?

I think ultimately the solution is not to make peer review better able to detect fraud, because that is very difficult to impossible, but to try to somehow get the message out that one small study of ANYTHING is really meaningless except as a possible kicking off point for more studies. It doesn’t really matter from a scientific perspective that Wakefield was fraudulent rather than just wrong. It was a study with twelve subjects and the results were never replicated. (Elizabeth Reid)

In the light of your remarks, if I thought you were a research scientist in a significant area of public interest, I would pull all your papers.

Why would somebody shrug off research fraud? Why would somebody say that Wakefield’s ability to place fraudulent findings on a matter of child health into the Lancet, and keep it there for six years in the face of all the public and professional scrutiny that it received, “doesn’t really matter from a scientific perspective”? (Brian Deer)

Brian, I think I may be able to clarify what is meant here by offering an analogy. I was a contributor to Wikipedia during the Essjay controversy. This was the furor which ensued when a long-time contributor by the pseudonym Essjay, who had posed as a tenured professor with multiple doctorates, turned out to be a college drop-out instead.

Now here’s the thing. In theory, it should have made no difference whatsoever that Essjay’s credentials had been faked — because his credentials should not have been the basis for accepting anything he said. When he said “X and Y and Z is canon law, and I should know because I have a doctorate in canon law,” the response should have been “Fine; if you have a doctorate in canon law then you should have no trouble finding the citations that back up your claim. Until you have those citations, we can’t move forward, because we don’t take anything just on the authority of some editor.” In practice, however, people had said “Well, I’m not so sure about this, but Essjay is absolutely convinced, and he’s an expert, so I guess that’s good enough for me.” Precisely because such credentials were rarely if ever verifiable, Wikipedia’s rules made quite clear: Do not accept a change just on the authority of some other editor. But in practice, people did anyways.

The relevance to the Wakefield affair is that, just as people should not have accepted any edits on the authority of Essjay’s credentials, a tiny study like Wakefield’s should have been at best a suggestion of an avenue of research to explore. Even if some magic oracle could have given us absolute unshakable assurance that Wakefield was completely honest — it was still a tiny study! The ability of such a tiny unreplicated study to prove anything is nearly zero; it should never have been taken as proof of danger in the MMR vaccine or need for a return to single vaccines or anything of the sort. That is what people mean when they say things like “it doesn’t matter that Wakefield’s results were wrong because of fraud” — of course they aren’t saying “oh, it’s okay that he exploited a weakness in the system out of cold-blooded greed and dishonesty,” they’re saying that the weakness in the system is the real problem. Should Wakefield have been exposed as a fraud? Is it important that his fraud be punished severely? Yes and yes; a thousand times yes. But we can’t stop there.

If Wakefield had been 100% sincerely convinced that his research had been accurate and all his results well-supported by his data, he would have led the world just as astray. The damage done by the promotion of his inaccurate results would not be one bit less, just because it wasn’t fraud that led his results to be incorrect.

Everyone is concentrating on the Lancet study, but Wakefield has many more papers. He attempted to strengthen and expand the Lancet paper with the O’Leary et al. paper in Molecular Pathology (PMID: 11950955). Why is there no scrutiny of this paper? Why no calls for retraction? The Mol Path 91 were victims of Wakefield, just like the Lancet 12.

Orac @48 Nicely stated. I think it probably goes without saying the Mr. Deer has suffered a tremendous barrage of hate and disparagement since this series began to appear. No doubt by now he has a collection of death threats as well given past history. I think it is understandable that he may be a bit frayed and sensitive to a perception, however incomplete or off base, that his efforts were somehow not necessary.

To Mr. Deer (in response to no particular comment) I would like to say that indeed we in the scientific community owe him a debt of gratitude for his diligence and persistence in discovering and exposing the full depravity of Wakefield’s many transgressions. The simple fact is we could not have done it. We are not equipped to accomplish such work. He did so in my opinion without generalizing and without paiting all science as fundamentally flawed but he perhaps has some justification for thinking that the medical research community (or a subset thereof) was unhelpful to his efforts and perhaps obstructive. The fact is he, and many people like Orac have for years tried to reassure the public at large that vaccines are both effective and tolerably safe. But I think too we must admit that it is Deer’s work that has driven the proverbial stake through the heart of the vaccines cause autism vampire meme. At least I hope it has.

I think to some extent Mr. Deer may misjudge us in thinking that if the scientific question is settled then we don’t care much about everything that swirls around that. That would be unjust. We do care, quite passionately, but we are constrained by the nature of science from allowing our emotions to determine our actions. In so far as that is possible.

Journalism and scientific reasearch are fundamentally different disciplines. Each bears some culpability in the grim saga of the vaccine scare in my mind because is it not true that without a vociferous and uncritical press response at the beginning of Wakefield’s fraud vaccination rates would have been unaffected? By this I do not in any sense mean to imply that Deer is in culpable for this. Rather that in both professions there are ethical and unethical practioners.

I don’t know to what extent Mr. Deer holds the medical reasearch community in general or some of its members responsible for any sort of ethical lapse or ‘malpractise’. He may in fact not at all do so. He may be just a bit miffed over the ivory tower’s notorious cluelessness.

In all, this particular play points up a few things though in broader context. It has to be admitted that science can be corrupted by lucre. It must also be admitted that some and perhaps much of mainstream journalism is in fact already corrupted by lucre. I think it is also apparent that both science and journalism have the ability to contribute to and benefit humanity, but only if they can retain credibility. Those of us who respect the ideals of both estates must cooperate or fail under the weight of amoral greed.

Wow, I’ve learned a lot from the comments so far, esp. Elizabeth Reid and Prometheus. It seems to be implicit in what they are saying that “from a scientific perspective” doesn’t mean “from a higher perspective” or “from a truer perspective”. In a sense, it means the opposite: taking a more limited perspective where you only care about whether the hypothesis is true. I imagine most scientists in the area are very interested to know that Wakefield committed fraud, as well as very happy that Brian Deer put in the work to catch him. It just doesn’t make much of a difference to their day jobs (except hopefully in the meta sense, of looking that the processes involved in research and publication).

I’m going to be boring and go back to the “improve peer review” discussion.
I like the idea of double blinding, and there doesn’t seem to be much to say against it. OK, so you could sometimes guess who the author is, but you can often guess who the reviewer is now too. On the flip side, I doubt I’d ever review an article again if I thought my name would get attached to it. I know how much animosity it is possible to build up against “That bloody reviewer”, especially when you feel the comments have been harsh, and I really don’t want it directed at me personally! But neither of those will help detect fraud. I think most reviewers feel that, in order to be able to review a paper at all, you have to assume that the authors are honest. Which shifts responsibility onto the editors. But then, if it took Brian Deer months of laborious work to find out the data were fraudulent, I don’t see how we could incorporate that into standard publication routines.

Can’t resist coming back to the subject of contention above: In the narrow focus of the link between MMR and autism, it didn’t matter if Wakers was a lying git or wrong a git, but I think it is highly relevant for science that he was fraudulent rather than wrong as it highlights the big holes in the publication system. Somehow, we need to fix this.

William, you would learn more if you read better, and didn’t just stop as soon as the first idea hit you.

If the detail of why both approaches are important escapes you, try asking questions. But a lot of people have tried to put it simply already.

Personally, I was convinced that Wakefield had committed deliberate fraud before I knew that he had misrepresented patients’ medical data — I figured that since I read the testimony about the Unigenetics lab PCR, and what was done.

Yes, exactly.

Some thoughts regarding replicability, good science, bad science, and fraud:

– Because surprising results tend to get published, and anomalous results tend to average out as numbers grow higher, we do sometimes get the effect that was discussed here recently, that various published “breakthroughs” aren’t borne out over time, even absent fraud or bad work. Someone does a conscientious study on a smallish sample, gets a surprising result, then later studies bring overall results back toward the mean. So not only can it be difficult to tell fraud from garbage, it can be difficult to tell both from good science done on a population that turns out to be anomalous. (Contrast fraud as ham-handed as Wakefield’s, which gets shown to be garbage pretty quickly, though it takes a lot more work to show actual fraud.)

– Back once again to the meaning for “pure” science of bad work vs fraud: I think it’s instructive that Brian Deer used the example of Piltdown Man. Better and worse paleontology has been done on Early Man for well over a hundred years, but Piltdown Man, as an outright fraud, has a special infamy. With the benefit of hindsight, we may congratulate ourselves on the performance of science regarding both Piltdown and Wakefield, but let’s not be too self-congratulatory; reputable scientists were taken in or were more interested in saving their reputations than in seeing scientific fraud exposed.

And the effects on future endeavors in the field are different as well. Science does not take place in a vacuum. Next time there’s a Senate hearing on issues dealing with research funding for childhood vaccines, just how vociferously negative do you think Dan Coats, good politician that he is, will allow himself to be? The exposure of Wakefield should make the research climate and public reception better for people like Paul Offit; perhaps he’ll get a couple fewer death threats this year (let’s hope for none).

So I don’t wonder that Brian Deer sees scientists as having huge blinders on when they say, “Hey, from a science standpoint, we had it handled.”

The problem with expecting work-a-day scientists to catch fraud is that they don’t have the time because they are not funded to do so. Doing peer review isn’t funded. Adding 10x or 100x more unfunded work on top of unfunded peer review isn’t going to work. If you want scientists to look for fraud more, then society has to fund them to look for fraud more, which means doing less new science.

The people who were taken in by Wakefield’s fraud were not scientists. They are quacks like Dr Jay (who apparently is still taken in), opportunists like Jenny McCarthy, cultists like AoA and MDC. Those people are not part of the reality based community. They didn’t arrive at their beliefs through facts and logic. Facts and logic will be unpersuasive at convincing them their beliefs do not correspond with reality.

I have no idea what it would take for Dr Jay to appreciate that Wakefield committed fraud. Trying to convince him is a fool’s errand. Dr Jay is unpersuaded by facts and logic, facts and logic are the only tools that scientists have. Faulting scientists because they can’t convince someone like Dr Jay using facts and logic is unreasonable. The “fault” is not with the scientists.

I am extremely grateful to Brian Deer for uncovering Wakefield’s fraud. Fortunately he was funded to do so. It is unreasonable to expect anyone who is not funded to accomplish such things.

Doing new science and finding new discoveries takes a different skill set than uncovering fraud. James Randi is more effective at uncovering fraud than many scientists because he has the required skill set to detect certain types of fraud. We don’t expect people who make things to be expert at apprehending people who steal things, or people who save lives to be expert at catching people who take lives, or people who make money be expert at catching people who steal money.

I think the largest potential problem is that in the quest to reduce scientific fraud, that scientific error is made into a crime. This is the problem in the criminal justice system, in the zeal of prosecutors to catch and punish someone, they convict innocent people of crimes they never committed. This is because prosecutors are rewarded for prosecutions, not for achieving justice, and not sanctioned for convicting innocent people.

We want and need science to be Byzantine fault tolerant.

http://en.wikipedia.org/wiki/Byzantine_fault_tolerance

That is the source of scientists not worrying as much about fraud as non-scientists think is appropriate. Wakefield’s fraud didn’t lead scientists to change their clinical recommendations. The science heuristic of weighting of evidence, of requiring independent replication, of looking at multiple lines of evidence simultaneously makes science Byzantine fault tolerant.

Scientists want to maximize the rate of progress in the scientific understanding of reality. Unfortunately requirements of the larger society can slow that down. Putting resources in fraud detection means less resources in new science generation. Attempted replication of questionable science is likely to be much cheaper than fraud investigation of questionable science.

I would like to know why there is no investigation of the lawyer who funded Wakefield to commit his scientific fraud? When outside forces (i.e. non-scientists) can commission fraudulent work with impunity, how are scientists supposed to prevent it? What would a scientist have done if Wakefield sued them for libel the way that Brian Deer was sued? The scientist would have had to settle.

I thought Deer’s investigation of Wakefield was very important, and a significant contribution to public health.

But from a scientific perspective, it didn’t tell me anything I didn’t already know. It was already established beyond doubt that Wakefield was wrong. What Deer did was tell us why it was wrong. But knowing why it was wrong does not alter my conclusions on any matter of scientific import.

Wakefield’s findings have been replicated, rendering fraud unnecessary.
See: Gonzalez, L et al (Arch Venez Pueric Pediatrica, 2005).
Balzoa, F. A J of Gastoenterology, 2005
Krigsman, 2009, Autism Insights
Horvath, K. J. pediatrics, 1999
Sabra, the Lancet, 1998
Furlano, R. 1998
Many such papers exist (Torrente, Ashwood) and the connection is being looked at more and more so keep the integrity, whether or not you like the results.

It is worth remembering that Wakefield’s paper was not the only dodgy “research” published by The Lancet. There were also the two papers offering wildly exaggerated figures for the number of casualties in Iraq.

I don’t think the standards of this magazine are very high.

Anon, those have been debunked so many times that I find it disgusting so many people keep bringing them up. Repetition doesn’t make it any more true.

Krigsman: hardly independent of Wakefield. Krigsman was Wakefield’s partner at Thoughtful House, and other authors were their employees.

Balzola: an abstract presented at a meeting 5 years ago, never published as a paper, which does not describe the same GI syndrome which Wakefield purported to have found.

Horvath: author of the long-debunked secretin “therapy”, at least there is no indication that he committed deliberate fraud; he was just shown to be wrong. Also didn’t describe the same GI symptoms or syndrome that Wakefield did.

Sabra: published a case study of two children with ADD and food allergies. Nothing at all to do with autism+GI.

Furlano: talked about the insufficiencies of mucosal defense in the intestines of individuals with some known types of GI diseases; did not confirm Wakefield, only marginally related by subject.

And so on.

In order for papers to support you, they need to be relevant, and, you know, support the assertion being made. FAIL.

Bravo Daedalus2u for a great comment, among many other good ones on the thread.

Re something that was said earlier (by dt, I think), there was no intimation or suspicion of fraud around the original 1998 Wakefield paper, as I remember it. There was, though, some skepticism over what was claimed, and recognition of the ways such small case series studies could be flawed – see e.g. the commentary that ran in the same issue of The Lancet by Robert Chen and Frank DeStefano of the CDC. Unfortunately it is paywalled, so only academic readers will be able to get at it, but among other things it says:

“Alternatively [i.e. if there is no objective laboratory test finding], a clinical or epidemiological study is needed to find out whether the rate of a given syndrome in vaccinated individuals exceeds that expected among unvaccinated controls. Such studies require acquisition of data in an unbaised way. Because of the inherent methodological limitations of epidemiological studies, biological plausibility, consistency, strength, and specificity of association must also be considered in inferring causation…

Is there selection bias [in the study]? The Wakefield report is based on cases referred to a group known to be specially interested in studying the relation of MMR vaccine with IBD [inflammatory bowel disease], rather than a population-based study. A first dose of MMR vaccine is given to about 600 000 children every year in the UK, most during the second year of life, the time when autism first becomes manifest. Not surprisingly, therefore, some cases will follow MMR vaccination. Biased case-ascertainment, as in this study, will exaggerate the association…

Was there recall bias? It is usually difficult to date precisely the onset of a syndrome such as autism. Parents and others may attempt to relate its onset to an unusual event such as coincidental postvaccinal reaction.”

Now, it is absolutely clear that Horton knew the original paper was going to cause controversy. It also seems to be the case (from various things that have leaked out) that the referees were of mixed views about the paper. Horton’s line has always been that he “thought it should be out there so that it could be looked at”. I would tend to see the Chen & DeStefano commentary running in the same issue as a way to contextualise the paper, or provide balance – or, if you prefer, a “CYA” (as in “Cover Your Ass”) tactic.

BTW, as Brian Deer has pointed out before, one of the damning things about Wakers is that he was asked, within days of the original paper and in a high-powered crisis meeting of folk from the MRC (cf US NIH) and the Dept of Health (slightly paraphrased):

“Let’s be quite clear, physician to physician – were these consecutive random referrals? Tell us how they came to you. We need to know to judge if there is a real MMR safety issue. Was there any element of patient recruitment/ selection?

– and he said no. This was one of things for which the GMC busted him, calling his saying this “dishonest” (Para 36 a & b, p 47-48 of the GMC Judgement).

Brian Deer’s latest article, at least the bit about Horton, relates largely to what happened in 2004, when Deer went public with a big chunk of his stuff on Wakefield. The Lancet, as he describes, rapidly published a series of short articles, including ones by Wakefield, by Murch and by Walker-Smith, responding to what Deer had said and denying pretty much all of it. These are the ones which Deer discusses and which show Horton in a bad light, particularly in terms of how they were organised.

Going back to what Daedalus2u said about the lawyer in the original case, the lawyer’s role is directly analogous to what would happen with a vaccine damage case in the US. The lawyer is acting as the parents’ (plaintiffs’) advocate, so it is a tricky point whether there is any duty upon them to be objective about the claims. So unless you thought you could unequivocally demonstrate deliberate intent to fabricate evidence, I would suspect there would be little chance of indicting the lawyer for anything, either in law or under their professional code. S/he is, they would presumably argue, “zealously representing their client’s interests”. Now, there are presumably legal association codes requiring them to advise their clients “in the client’s best interests” – which one might say now was not to be party to the lawsuit – but again I doubt that claiming they had failed in that duty would stick.

NB – IANAL – or an MD…!

Also, Gonzales — found a higher incidence of GI problems in autistic kids than in controls, but no distinct syndromes. Did not replicate Wakefield’s findings.

And if you were thinking of further papers by Furlano — the ones he did that were directly relevant to Wakefield’s assertion, were done with Murch and Walker-Smith, Wakefield’s co-accused — again, not exactly “independent.”

Krigsman: hardly independent of Wakefield. Krigsman was Wakefield’s partner at Thoughtful House, and other authors were their employees.

Also, Wakefield was on the editorial board of Autism Insights, the “journal” where this “study” was published.

And this is how the amazing Krigsman wound up as a doc at Thoughtful House:

Before moving to Texas, Krigsman conducted research related to this speculation [a connection between MMR, intestinal inflammation and autism] at Lenox Hill Hospital in New York City. In 2002, the hospital’s Institutional Review Board became concerned that he was doing unnecessary colonoscopies as part of an unapproved research project. Court documents indicate that he did not fully cooperate with the hospital investigation and ultimately filed suit when the hospital restricted his privileges. In February 2004, the Florida Medical Board assessed an administrative penalty of $1,000, plus $89 in costs, for failure to document continuing medical education required for initial licensure. In April 2004, as noted below, He applied for a Texas license in November and resigned from the hospital staff in December. In 2005, he signed an agreed order under which the Texas Medical Board agreed to license him but assessed a $5,000 penalty for (a) failing to disclose the Florida board action, and (b) while still unlicensed in Texas, misrepresenting himself as being available see patients in Texas.

Anon, any more “scholarly articles” you’d like to cite by doctors fired from New York hospitals, barred from practicing medicine in Florida, and fined for dishonesty in Texas?

In the US, lawyers are considered to be “members of the court”, and so are forbidden to do things like suborn perjury, you know, like pay someone to generate false testimony no matter how much it helps their client. Non-lawyers are not allowed to do this either, but lawyer have “lawyer client privilege” which allows their discussions with their client to be non-discoverable.

The lawyer is not obligated to be objective about the claims, they are required to be truthful. If they cross the line and are not truthful, they should be sanctioned, disbarred and go to prison.

A lawyer can’t advise their client to commit a crime, or they become an accomplice to that crime. Lawyer-client privilege becomes nullified if the lawyer knows of the client’s willingness to commit a crime and allows it to happen unreported and continues with their representation of that client. They are not then engaged in lawyer-client activities, they are engaged in a criminal conspiracy to commit crimes.

Of course when lawyers commit fraud it is more difficult to catch than when scientists commit fraud. There is even less will among lawyers to try and catch other lawyers committing fraud than there is among scientists to catch scientific fraud in my opinion.

Wakefield –

First met Barrs solicitors in Jan 1996, and formulated research study to “prove” MMR damage later that spring.
Lancet paper was published Feb 1998 (submitted earlier).

The time spent on legal work? According to Wakefield, he got £150 per hour, and he accrued £435k as shown by Deer.

That’s 2900 hours, all done within 2 years.

I’d be interested to see the invoice for the work Wakers submitted to the solicitors. I for one cannot envisage how he could do legal work for the equivalent of more than 4 hours a day, for 365 days a year, with no holidays, no weekends off, and all on top of his normal job.

Is someone somewhere telling porkies?
Now either he got far, far more than £150 per hour, or his submission of hours worked to Barrs solicitors was somewhat economical with the truth.
Maybe Barr’s should look at this?

@dt

Was it really all supposed to have been done within those two years? That certainly would be a hell of a lot of hours to cram into Wakers’ working week. From memory, when the jaw-dropping £ 435 K figure first hit the press, Wakers did make some statement along the lines of claiming he had spent “every spare moment” on the case (i.e. all his evenings and weekends) for “several years”. I guess this is on Brian Deer’s website somewhere.

@daedalus2u

The “officer of the court” thing certainly applies in the UK too. But the problem is that you would have to prove the lawyer deliberately mislead the court, or allowed something to go before the court knowing it was misleading. This would be exceptionally hard to prove, I think. The wordings we have, that with hindsight look a bit jarring (“find evidence to prove…” a connection between MMR vaccination and IBD, for instance) all come from proposals to get legal aid (state assistance to people to allow them to bring a case). As these applications go to – presumably – other lawyers and state officials, the language cannot have been that out of line with the usual. I guess the lawyer just has to say:

“Well, based on what my clients told me, I believed, as they did, that there was a case and the evidence would be there. All we were asking for was the money to do the research to substantiate and document the connection we believed was there.”

It might sound hinky to a scientist put like that, but I fear we have to accept that to a lawyer it is nothing special… and it would not be regarded as in any way analogous to (for instance) suborning perjury – not unless they had written invent evidence” rather than “find evidence”.

Incidentally, the lawyer in the case, Richard Barr, still seems very proud of his MMR work and mentions it prominently on his various websites – see e.g. here.

The idea that peer review should be a kind of preemptive fraud investigation is naive. To begin with, it would impose enormous costs. Look at the amount of time Deer had to invest to expose Wakefield, and Wakefield’s misdeeds were not even all that well hidden. Peer review is pro bono work for scientists. It is time-consuming, doesn’t much help our careers, and we don’t get paid to do it.

While reviewers examine data when they review a publication, it is usually in the form of summaries, not raw data. One might imagine that detection of fraud would be improved if reviewers were provided with the raw data, but this is rarely the case. For most types of research, providing the raw data to the reviewers would add very little additional confidence, even if they had the time to reanalyze it in detail (and analysis of raw data tends to be extremely time consuming). Yes, there are a few types of data, such as instrumental data used in climate science, where this is worthwhile. But for most types of research interpreting the results requires more than the raw data. You have to know the provenance of the data: exactly how the experiment was done, and assurance that the data has not been altered along the way. If you aren’t going to trust the author’s stated methods, then there would have to be some kind of procedure for documenting every aspect of data collection (video maybe?) in a manner that was time stamped and watermarked to prevent alteration. You’d need not merely the data that was included in the study, but also some way to verify that no data was improperly discarded, because it is possible to bias a conclusion by leaving out certain data even if the data presented is accurate. And of course, all materials and data generated would have to preserved in a non-tamperable format. The cost and loss in productivity would be enormous. And for the most part, the benefit would be marginal. Even if all of this could be implemented, it is doubtful that it would enhance the progress of science. Identifying fraud can be very time-consuming. Keep in mind that Wakefield’s work had already been shown to be wrong, and discounted by essentially all scientists working in the vaccine or autism field, long before Deer was able to bring his investigation to a conclusion, simply on the basis of conventional science, which failed to confirm or replicate Wakefield’s conclusions.

PS Perhaps the most accessible article on lawyer Richard Barr and his role in the UK MMR case is this one by Dr Michael Fitzpatrick. One thing it discusses, which I had forgotten, was that prior to the MMR business Barr had run “class action” type cases on Gulf War Syndrome and on organophosphate agrochemicals. Both cases subsequently collapsed when lawyers finally admitted there was no chance of winning them in court.

For most types of research, providing the raw data to the reviewers would add very little additional confidence, even if they had the time to reanalyze it in detail (and analysis of raw data tends to be extremely time consuming).

@trill: That’s why I suggested that raw data and source code should be made available to the public, as much as possible. More than allowing people to uncover fraud, it would deter it.

I subscribe to the open-source dictum as stated by Eric S. Raymond: “given enough eyeballs, all bugs are shallow.” (I do disagree completely with some of Raymond’s other views, like those having to do with AGW.)

Wakers says at 3:21 on this clip on ABC Good Morning that he had never heard of any lawyer until Jan 96.
http://abcnews.go.com/GMA/video/vaccine-autism-link-called-elaborate-fraud-12631458

Also confirmed by Brian Deer in his first article in the BMJ:

“Claiming an undisclosed £150 (€180, $230) an hour through a Norfolk solicitor named Richard Barr, he had been confidentially 8 put on the payroll two years before the paper was published, eventually grossing him £435 643, plus expenses.”

I guess, as the legal initiative and “study” mirrored the research he was doing already at the Royal Free he may have been getting paid twice for doing exactly the same study- collecting his own salary for the work and then claiming for it as part of his legal work too.

That’s a reasonable explanation I guess.

Much love to Mr. Deer and Orac. I am convinced that you are both truly good people and I agree with the rest of your fans here that we can applaud you for your courage and your willingness to sacrifice your own time and energy to help the rest of us. We certainly need it.

Science is supposed to be self correcting. It is in its’ nature. That is what I was taught. That is my only “faith”.

But in the case of the Lancet and Wakefield… it just took too damn long. Long enough for a very large number of credulous (and generally educated) people around the planet to buy a whole lot of total bullshit that has become the anti-vaccine meme.

And now, here in the Mecca of woo, we have diseases we thought were gone. We have people, who even after being told the truth, have so accepted the “Wakefield, McCarthy, Oprah” propagated anti-vaccine meme, they still believe the meme and appear to have developed an anti-body to the newly evolving anti-meme. Even with the factual proof of Wakefields’ fraud they still buy the meme. (Sounds like a religion.)

I tried to write a letter to the editor of my local paper about our local vaccine situation. I called the local high school nurse to get the statistics regarding immunization waiver rates in the school. I was referred to the county health department and after two phone calls (and none of the promised responses) I came to the conclusion that a factual percentage of vaccine waivers for our school is not going to be given to me without a legal fight.

My (thoroughly un-scientific) straw poll indicates that 60% of kids in my local elementary and high schools are un-vaccinated. 60%. Put on your science cap and consider the implications of THAT number.

As far as I can see, in my community, the damage is done. The stupid anti-vaccine meme is out of the box and it will take a tremendous amount of work to stuff it back in. If it really ever can be.

Any victory for science and rationality is cause for celebration in my little woo-dominated world. And every victory comes about because of brave, dedicated, self-sacrificing heroes…

Like Mr. Deer and dear Mr. Orac. May you both live long and prosper.

Dr Aust @73 &74

Incidentally, the lawyer in the case, Richard Barr, still seems very proud of his MMR work and mentions it prominently on his various websites

&

prior to the MMR business Barr had run “class action” type cases on Gulf War Syndrome and on organophosphate agrochemicals

Is this the Richard Barr who is a director of the Society of Homeopaths? His profile is second from last.

http://www.homeopathy-soh.org/about-the-society/Bod.aspx

Following up on Elizabeth Reid, Promethus, and Midnight Rambler:

In short, it was a bad study, even if it hadn’t been a fraudulent study, and greater awareness and acceptance of why it was bad would have, and in future cases should, serve to kill it dead before the fraud aspect even came up.

@MilitantAgnostic

“Is this the Richard Barr who is a director of the Society of Homeopaths?”

The very same. His wife Kirsten (Limb), who he describes in his SoH profile as “starting to train as a homeopath”, is (according to internet sources, including Brian Deer’s blog) a former client of his who then became his secretary and assistant, and later married him. At the height of the MMR legal case she was employed as the chief “scientific researcher” in Barr’s team, although if she has any scientific qualification (and I’ve never seen it definitively documented) it would only be a Bachelor Degree.

Some internet rumours in the law blog underworld suggest that Barr and his firm were charging the legal aid fund (i.e. the British taxpayer) something close to £ 200 (US $ 300) an hour for Kristen’s time working on the MMR case, though again I’ve never seen an authoritative statement of this. The standard rate the fund paid actual lawyers for court appearances at the time was said to be closer to $ 50 an hour.

While everyone now recalls the headline figure of £ 440K (c US $ 700K) that the English legal aid fund paid to Wakefield, one should remember that the fees paid to the lawyers were an even more eye-watering 10 million pounds (say $ US 15-16 million or thereabouts). About 5/6ths of this money went to solicitors, which would presumably largely mean Barr’s outfit. All the figures are here.

Dr Aust @81
WTF – You’re saying British taxpayers funded Wakefield’s scam.

Was Kristen married to Barr at the time that he was billing the taxpayers for her “scientific” services?

I wonder why the Society of Homeopaths connection hasn’t been given more attention. I find it interesting that a Lawyer who makes his living from bogus claims against “conventional” medicine is a director of an organization that dissuades people from using “conventional” medicine in favor of bogus treatments.

@Militant Agnostic

“You’re saying British taxpayers funded Wakefield…”

Exactly. In the UK if you didn’t/don’t have the assets to pursue certain kinds of litigation (and also other things like criminal defense) you could then apply for what was called “Legal Aid”, basically assistance with your legal costs from the taxpayer. So the bill for the MMR litigation of £ 15 Million pounds – payments to lawyers, to the extensive slate of “experts” including Wakers, for the initial work in his lab and for Unigenetics in Dublin – all came ultimately from the British taxpayer.

Of course, in the US the lawyers also do nicely out of the vaccine injury cases, but there (as I understand it) it is a levy on the vaccine manufacturers that foots the bill.

Not sure when Barr and Limb married. Brian Deer would know.

Barr’s role with the Society of Homeopaths has had some attention in the blogosphere, but not much more widely. I suspect this is partly because his SoH role is recent, while he doesn’t seem to have been involved with any major “class action” type litigation since the MMR legal case went down the pan in 2003. Another reason could be that Wakefield has always got so much of the MMR attention that the other players were rather forgotten.

The legal blog underworld does offer hints that at some points questions may have been asked over Limb’s and Barr’s conduct, at least internally within the law firms they worked for. Over the lengthy lifetime of the MMR suit (which in various forms ran from 1992 until 2003) Barr (and later Limb) certainly moved from one law firm to another several times, taking the litigation/case(s) with them.

Thankyou, Joseph, for your points about raw data. A Harris poll from last week found only slightly more than half of respondents believed vaccines doesn’t cause autism. The vaccine program would seem to be in crisis and I really believe the research can be bettered and maybe the administration of some could be re-considered- say chicken pox or hep b at birth ( unless of course the parents want/need the hep b at birth.

I stopped subscribing to and reading The Lancet in the late 80’s when it became obvious to me it was happy to publish trash that couldn’t get published elsewhere, and its politicized editorial policy was very slanted. I would never use it for reference or scientific attribution after that.

@joseph
There is nothing magic about raw data, and no reason why making it available would deter fraud. It is just as easy to fabricate or alter raw data as to fabricate summarized data. Typically, raw data is just a list of numbers. You are still trusting the experimenter’s word about how those numbers were acquired, what each number represents, and what the experimental conditions were. The notion that availability of “source code” would be useful to check scientific results seems to be a widely held notion among amateurs. As a scientist, I find that computer source code is far too low-level and difficult to read to be useful for checking somebody else’s work. Debugging somebody else’s computer code is a pain even when it is a finished product produced with modern structured programming methods. Doing it for code dashed off for one-time use, with minimal documentation, by a scientist who probably learned programming “in the gutter” would be a nightmare. I can’t think of even a single instance in which fraud or even an important error was identified by reviewing another scientist’s code. If I want to check another scientist’s work, I want something more high-level than computer language code–I want the math. I can write my own code from scratch, and that way I don’t risk inheriting somebody else’s bugs (or hidden data tweaks, for that matter).

Brian Deer seems to think that scientists are taking Wakefield’s fraud lightly. I guess I can see how he got that impression, but he is very much mistaken. Because science is so dependent upon trust, fraud makes scientists absolutely livid. It is a betrayal of one’s colleagues, and a betrayal of the entire discipline of science.

But when it comes to Wakefield, most scientists were already pretty livid, because even if his results had been exactly as he represented them to be, for him to speak to the press and suggest, based on a case study of only 12 individuals, that vaccines are a danger to children was the height of professional irresponsibility, and virtually certain to result in an increase in childhood illness and deaths from vaccine-preventable diseases. It’s hard to get any more angry at the guy. So when we learn that it was actual fraud for financial gain, we just tend to nod sadly, and say, “It figures.”

But trrll, IF the scientific integrity backing the vaccine program is shaky in some instances (Fombonne and Madsen come to mind) then you should be just as angry about that because that is also the height of professional irresponsibility and will ultimately cause doubt toward the vaccine industry. And what about a larger sample primate study looking at vaccinated VS unvaccinated and comparing brain growth, etc. etc.?

But trrll, IF the scientific integrity backing the vaccine program is shaky in some instances (Fombonne and Madsen come to mind) then you should be just as angry about that because that is also the height of professional irresponsibility and will ultimately cause doubt toward the vaccine industry.

And if the allegations you reference are absolute nonsense, spread by the same sort of gnorons* that promote other known false claims such as “Paul Offit said we should inject every baby with 10,000 vaccines” and “Poul Thorsen disappeared” and “vaccines contain antifreeze” then there is no reason to be angry except with gullible fools who parrot this nonsense uncritically.

* A “gnoron” is like a moron, except that where a moron is lacking in intelligence (something they cannot help, of course) a gnoron is someone of decent intelligence whose own willful ignorance has brought them to an equivalent state of incompetence.

“Dr. Jay” opines:

“The Lancet did their job poorly and now BMJ’s hit man is crying ‘fraud.'”

No, I’d say that the evidence is crying “fraud”. Mr. Deer is simply the (very articulate and skilled) messenger.

Not feeling that he has adequately humiliated himself, “Dr. Jay” continues:

“I doubt that Wakefield committed fraud…”

And you base this belief on…? So, despite the evidence presented (which was not – as “Dr. Jay” seems to imply – based solely on Mr. Deer’s “journalistic experience”), “Dr. Jay” prefers to rely on his “gut feeling”. Isn’t this just typical of “Dr. Jay’s” reasoning processes?

But wait, there’s more!:

“They both [Wakefield and Deer] have exaggerated and we now get to choose which of the two has good intentions and which has a vendetta.”

To begin with, Mr. Deer has documentation supporting his statements, something Dr. Wakefield seems to be lacking. Secondly, Dr. Wakefield didn’t “exaggerate” – he lied – and if “Dr. Jay” thinks that Mr. Deer is “exaggerating”, does he have any evidence to support that claim or is it – again – based solely on his “vast clinical experience”?

“Dr. Jay”, when you find yourself in a hole, it’s time to put down the shovel.

Prometheus

One notes that, as usual, Dr. Jay has, like brave, brave Sir Robin, bravely turned his tail and fled. No doubt he’ll pop up again in a different comment thread saying the same thing with the same lack of any supporting evidence to back up his “feeling” that Deer is “biased” and therefore not to be believed.

#90

A “gnoron” is like a moron, except that where a moron is lacking in intelligence (something they cannot help, of course) a gnoron is someone of decent intelligence whose own willful ignorance has brought them to an equivalent state of incompetence.

Excellent Antaeus Feldspar!
I see “gnoron” hasn’t yet been defined in the Urban Dictionary?

Perhaps you could add an entry? You could even use Jay Gordon as an example.

There is nothing magic about raw data, and no reason why making it available would deter fraud. It is just as easy to fabricate or alter raw data as to fabricate summarized data. Typically, raw data is just a list of numbers. You are still trusting the experimenter’s word about how those numbers were acquired, what each number represents, and what the experimental conditions were.

@trill: No, I don’t think so. It’s not easy to fabricate raw data on complex phenomena that looks like real-world data. You could bias it (by removing inconvenient data points, for example) but here’s the thing: When a study fails to reproduce, you would not only know that the results differ, you would also know why. You would know exactly how a team biased their data compared to all others.

As a scientist, I find that computer source code is far too low-level and difficult to read to be useful for checking somebody else’s work. Debugging somebody else’s computer code is a pain even when it is a finished product produced with modern structured programming methods.

The usefulness of making code available is mostly in that it would just make everything more transparent. More transparency would simply be better for science, presumably.

But by making it publicly available, the odds that someone somewhere in the world might scrutinize the code and find something of interest increases. They could find a simple way to optimize it, or an obscure bug, which would otherwise not have been found (or found slowly through the traditional scientific method.)

I don’t see what’s not to like about this idea.

(BTW, there are methodologies already that work faster than the traditional scientific method, namely data science competitions.)

#91

“Dr. Jay” prefers to rely on his “gut feeling”.

Relying on gut feeling is the logical way to go when you are pulling your evidence out of your ass. Keep all thought processes in the digestive tract.

“Dr. Jay”, when you find yourself in a hole, it’s time to put down the shovel.

He does put down the shovel, but then he calls in a backhoe.

I second the call for Antaeus Feldspar’s “gnoron” neologism to be entered in the Urban Dictionary.

@joseph
No, it is just as easy to fabricate raw data as it is to fabricate summarized data. If anything, it is easier. You generate the data from your model and then add random or pseudo-random noise from a plausible distribution. On the other hand, if you fabricate summarized data, like means and standard errors, it is easier to trip up and give yourself away, because the scatter of your means would have to be consistent with your stated standard errors (indeed, the most common way in which people get caught fabricating data is by making the data too good). in fact, the safest way to do it would be to fabricate the raw data and then summarize it as you would for real data).

“Transparency” sometimes seems to get thrown around as a meaningless term. Compared to mathematical equations, computer code is obfuscatory, not transparent. And having people trying to optimize somebody else’s one-off code is pretty much a waste of time. One can almost always do a better job more efficiently by recoding an algorithm from the math than by trying to figure out somebody else’s code well enough to optimize it. I can’t think of a single case in which an important scientific error, let alone fraud, was discovered by inspection of somebody else’s computer code.

It is worth looking at the example of what happened in climate science. Some hackers broke into Phil Jones’s email, found a scrap of code, and based upon their “analysis” of that code started to insist that the Phil Jones’s data analysis was fraudulent. Meanwhile, other people wrote their own code from scratch, carried out their own analysis, and replicated Jones’s conclusions, proving them to be correct. So this is a clear case in which code inspection turned out to be obfuscatory, while independent analysis with independently generated code yielded the correct result.

This is not to say that there aren’t cases where sharing of code is useful. Most scientists routinely make software tools that they have developed available to other scientists who might want to use them. But this is sharing of tools, not checking results (although real errors are far more likely to be detected in actual use than by reading through the code).

Jen, your concern for protecting the vaccine industry from “doubt” is touching. I certainly agree that without ironclad evidence, casting doubt upon the use of vaccinations that have been proved to save children from death and disability is the height of irresponsibility.

“I second the call for Antaeus Feldspar’s ‘gnoron’ neologism to be entered in the Urban Dictionary.”

I go with that. Too useful a word to not have an entry for.

“They both [Wakefield and Deer] have exaggerated and we now get to choose which of the two has good intentions and which has a vendetta.”

Heaven forbid that one should look at the documented evidence as an aid to making one’s choice.
Dr Gordon’s current argument seems to be that Wakefield’s research might have been rubbish but his intentions were good. The trouble with this “good intentions” issue is that it only matters to someone who thought well of Wakefield in the past and is now trying to minimise that misplaced support… in other words, someone who thinks that it’s all about him.

You generate the data from your model and then add random or pseudo-random noise from a plausible distribution.

@trill: Which would be very foolish. There are people who are very adept at reverse engineering. Pseudo-random number generation algorithms are well known. I think someone engaging on this type of fraud could be found out.

More practically, though, I have never heard of anyone doing this — i.e. automatically generating fake data, making it publicly available, and people being fooled into thinking it’s real-world data. When data is publicly available, bad science based on that data typically involves cherry-picking or incorrect analysis.

Additionally, a lot of “raw” data can be reconstructed from a more basic database or source material. Certainly, in these cases, knowing that the raw data has been publicly released is, in my view, a reassurance about the integrity of research.

Compared to mathematical equations, computer code is obfuscatory, not transparent. And having people trying to optimize somebody else’s one-off code is pretty much a waste of time.

I completely disagree with this. If it were the case, open-source software would not exist. Reality is that it’s possible for non-corporate entities with little funding to produce complex software, collaboratively, only because of openness.

I can’t think of a single case in which an important scientific error, let alone fraud, was discovered by inspection of somebody else’s computer code.

I can’t see how you’d expect this, when there’s so little source code available for scientific work.

But in fact, source code is available for some scientific models, e.g. climate models released by NASA. It’s clearly in the public interest for such source code to be made available, so that others can learn from it, and perhaps improve on it.

It is worth looking at the example of what happened in climate science. Some hackers broke into Phil Jones’s email, found a scrap of code, and based upon their “analysis” of that code started to insist that the Phil Jones’s data analysis was fraudulent. Meanwhile, other people wrote their own code from scratch, carried out their own analysis, and replicated Jones’s conclusions, proving them to be correct. So this is a clear case in which code inspection turned out to be obfuscatory, while independent analysis with independently generated code yielded the correct result.

I’m well aware of this case, and indeed, I wrote a post in rebuttal of Eric S. Raymond’s botched analysis of one such piece of code.

The problem in this case was that, as I recall, this was test code that was commented out, and never actually used in a publication (in addition to being largely misinterpreted.) Researchers have all kinds of hypothesis-testing crap in their hard-drives that never sees the light of day. Seeing these scripts was nowhere near the public interest, and that’s the difference.

When researchers release their raw data and source code to the public, they would be encouraged to make sure it’s error-free, which is an added benefit.

Well, trrll, I would agree that without having iron clad evidence, doubt upon the vaccine industry is inevitable ( that goes to efficacy and safety).

Except that there is no doubt that pertussis, measles, mumps, Hib, polio, diphtheria, tetanus and the rest cause disability and death, and at a million times higher rate than vaccines. Which would you prefer, Jen? Oh, wait don’t answer that. We don’t really care what you think.

Another take on medical journal and mainstream media responsibilities in the wake of the continuing Wakefield debacle, from the head of the research institute at Nationwide Children’s Hospital in Columbus, Ohio, Dr. John Barnard:

“Millions of dollars have been spent disproving any link between autism and MMR, dollars that could have been used to pursue meritorious autism research. Thousands of children have suffered with preventable and potentially fatal childhood diseases because vaccinations were not given.

When a research report makes an extraordinary claim, especially one that has serious public-health implications, medical journals and the peer reviewers they use must raise the bar, taking care to demand extraordinary evidence.

Similarly, the news media should scrutinize and report extraordinary claims in a more-detailed, rigorous and responsible manner. Doing so will most certainly reduce the likelihood of regrettable events such as this saga.”

@joseph

You are mistaken about pseudorandom number generation algorithms. There are quite a few of them, they look perfectly random under all standard statistical tests (which they have to, to be useful), and they produce very long nonrepeating sequences which can be different depending upon the seed, and of course it is trivial to shuffle the order. It would be enormously difficult to distinguish between a pseudo random number generator and real random numbers. If it were easy to reverse engineer a pseudorandom number sequence and identify the algorithm, you’d see mathematicians coming home big winners from Vegas, because modern slot machines all generate their results by pseudorandom number generation.

In fact, some fraudulent science is even more sophisticated than this. There have been a number of examples of frauds in which the data is quite genuine, but the experiment is not as described. There have been cases, for example, of fraudsters “doping” experimental preparations with proteins or chemicals to simulate a desired result. We’ll never know if Wakefield’s PCR results, which nobody could reproduce, in which he claimed to find persistent measles virus nucleic acid in autistic children were accidental contamination or doping.

Reviewers sometimes are able to catch bad science, such as dropping data or using the wrong analysis (and raw data would not be a great help here, either), but intentional fraud is hard to catch. In cases where people have been caught by inspection of raw data, it is almost always because the experimenter clearly never expected anybody to actually look. If the raw data were routinely published, this would provide an incentive for a fraudster to take the extra step of fabricating the raw data–which would cover his tracks better and make it much harder for an investigation to prove fraud.

You are mistaken to compare open source software, which is created as a team effort, using version control software designed to facilitate projects, with debugging of code that was written by an individual for his own personal use. Open source software development, like commercial team development of software, works because everybody is following a set of protocols designed to facilitate code sharing.

NASA has always shared source code with other scientists. Public release has been mainly in response to demands from global warming deniers. These seem to reflect a political maneuver as opposed to a sincere desire to make use of the code (“they must have something to hide since they don’t want to release the code”), as most of the loudest voices seem to have little interest in the code or data that actually has been released. At this point there is a huge amount of climate model and analysis code available, yet not a single major error affecting conclusions, much less any example of fraud, has been found by the public. Considering all of the work required to make this code accessible and put it in a comprehensible form, this has been a substantial diversion of scientific effort away from actual science into what is ultimately an exercise in public relations. This is probably unavoidable, given that there are powerful financial interests that are threatened by public awareness of the reality of global warming, but it would be unfortunate to see this spread across all of science.

I think that researchers have a pretty strong incentive to make their code error free already. While the likelihood that an important error would be found by the public inspecting your code is pretty near zero, any important conclusion will ultimately be replicated by other investigators, using their own code written independently. Having your competitors show that your conclusions were wrong because you made a programming or math error is any scientist’s worst nightmare.

Richard Barr has this on this SoH biography:

“Although he is not a homeopath, he has become interested in it ever since his wife Kirsten started to train to be a homeopath after experiencing at first hand some spectacular results following homeopathic treatment – including helping her daughter to recover from a severe brain inury after she had been damaged through medical negligence.”

Can anyone tell me if Barr argues or believes that the ‘medical negligence’ in question is vaccine-related (or not)? I’m guessing not, but it’d be good to know.

@trill: You might be interested in this paper about detecting pseudo-random number sequences (generated by MATLAB) using machine learning techniques.

Of course, this is very theoretical, because I don’t believe it has ever happened. If you fake raw data or tamper with source code, it’s highly unlikely you’d make either of it public. Fraudsters presumably avoid openness.

In fact, some fraudulent science is even more sophisticated than this. There have been a number of examples of frauds in which the data is quite genuine, but the experiment is not as described.

Of course, and I’m not claiming that what I suggested solves the problem of fraud in its entirety — and it probably can’t ever be solved 100%.

Perhaps Brian Deer is right about random audits. Researchers, as a standard practice, could keep meticulous logs of their experiments.

Open source software development, like commercial team development of software, works because everybody is following a set of protocols designed to facilitate code sharing.

Yes, but it is the case that people outside the core team often submit patches for bugs. (Even in relatively small projects, I’ve seen this happen.)

NASA has always shared source code with other scientists. Public release has been mainly in response to demands from global warming deniers. These seem to reflect a political maneuver as opposed to a sincere desire to make use of the code (“they must have something to hide since they don’t want to release the code”), as most of the loudest voices seem to have little interest in the code or data that actually has been released.

I realize that the motives of deniers when they call for increased transparency are disingenuous and conspiracist. That doesn’t mean they are wrong about transparency, though.

Indeed, climate science is probably the field of science with the largest availability of raw data. I don’t believe any climate scientist would say this is anything but a Good Thing. Imagine if everyone working on a climate model had to produce their own CO2 reconstruction or have to beg Etheridge et al. to provide them their private data.

Raw data can also be used to decisively counter denier conspiracies, e.g. when Tamino debunked the “station drop-out” conspiracy and his analysis was widely replicated.

Chris, I would rather have really good evidence that the vaccine works ( look at how many people coming down with pertussis had the pertussis vaccine. Also look at what Cochrane reviews have to say about flu shots!). Secondly, I would like to know that they are safe. A primate study comparing vaccinated vs unvaccinated and looking at lots of different bio-markers would be a good start. A new Harris poll shows that almost 50 percent (48%) of people think vaccines and autism could be connected. That’s a disaster that can’t be wished away.

Jen–

Yes, it is unfortunate that a lot of people mistakenly think that vaccines and autism might be connected. Your demanding frankly impossible standards of proof for vaccine safety–and not for anything else–is contributing to this false belief.

Safety has been studied, and proven, repeatedly. If you don’t think the standards for vaccine safety are adequate, you shouldn’t be going to the doctor. Not because the vaccines are questionable, but because your transportation to the doctor is not proven safe by those standards. Not walking, not driving a car, not bicycling, not taking a train.

Try turning it around: can you prove the safety of _not_ vaccinating a child against measles, pertussis, diphtheria, tetanus, or polio?

If you seriously want to keep yourself and your children safe, don’t focus on one unlikely risk. Try minimizing total risk. So, yes, you can drive, but choose a car based on its safety record; be careful on ice; wear seatbelts; and get the brakes checked regularly. Get your kids vaccinated, and make sure they wash their hands regularly, and wear hats on cold days.

Jen, you really are clueless. I said we really don’t care about your very uneducated opinion. You are using the Nirvana fallacy and thinking a vaccine should be 100% effective before it will every be used.

That will never happen in the real world.

As we have told you multiple times the DTaP is about 80% effective, therefore there needs to be a certain level of people who need the to be vaccinated to keep the disease at bay. I have posted the herd immunity math for you more than once. I will not waste my time doing it again.

Because you are gnoron who does not comprehend anything beyond your point of view.

Well, Vicki, I do want to keep myself and my children safe, so I have taken our health history into account ( which includes allergies) and have vaccinated my son minimally, as I have stated before. And worn hats on cold, days, washed hands, etc. etc.

And Chris, I don’t think it’s moronic, gnoronic or even un-scientific to be thinking that more could be happening with environmental research into autism when it is growing at the rate it is and approximately 1 in 100 children are affected.

jen,

One concern I have about minimally vaccinating is that if there is a risk to vaccination (and there is, of course, albeit a small one), then if you do not fully vaccinate, you are accepting that risk for reduced benefit.

The way I look at it is this. If vaccines cause autism in a small section of the population with a particular susceptibility, then I am taking a similar risk whether I vaccinate fully or partially. The risk will probably higher with more vaccines, but not very much higher. Still, why take extra risk if you don’t need to?

Well, do you need to? DTaP is supposed to be given four times by age 18 months. This is because of effectiveness concerns; studies through the years have shown that just giving it once doesn’t usually produce enough protection. So if I have my child vaccinated just twice for it, am I accepting a possible risk of autism without actually gaining protection against diptheria, tetanus, and pertussis?

I’m not an expert; I don’t know how much incomplete vaccination actually compromises immunity. To use Ye Olde Seatbelt Analogy, would certain schedules be analogous to wearing a seatbelt but putting the shoulder strap behind my back (thus accepting the risk of entrapment without gaining the full benefit of crash protection)? I do not know, but it’s what I’d worry about.

(Note: I am speaking largely hypothetically here, jen. I don’t know what your child’s schedule actually is, and maybe it does confer adequate protection. I don’t know; this is just to illustrate my general concern with delayed vaccination schedules.)

@ Jen:

And what rate is that? Last I checked, there’s still no good evidence that the rate of increase in autism is non-zero. The rate of autism diagnosis, sure, but as has been rehashed ad infinitum ad nauseum, that does not demonstrate that the actual underlying rate is increasing.

Chris, I would rather have really good evidence that the vaccine works ( look at how many people coming down with pertussis had the pertussis vaccine.

That’s interesting. I for one would really like to have some reassurance that handedness doesn’t increase the risk of pertussis; look how many people coming down with pertussis were right-handed.

Obviously the fact that they make up the majority of the population has nothing to do with them also being well-represented among people coming down with pertussis.

About people with pertussis vaccine later catching pertussis — I rather suspect immunity is short-lived. The main focus in the schedule is on protecting very small children, but I think they should be recommending more frequent vaccination for pertussis after that — bottom line is I suspect most people vaccinated against pertussis are now *under*vaccinated against pertussis. And since very nearly everybody has been vaccinated against pertussis at some point, I think just statistically you’re going to find more people who have been vaccinated getting pertussis than not. There’s just so many more in the former category than the latter.

Jen, I’ll try and remember to look through those later today. I’ve never been much worried about proving a lack of a connection, in part because it’s a logical absurdity — you can’t prove a negative. My focus has always been more on the positive side. Can you prove there *is* an association? I have not found any of the evidence in favor of an association to be persuasive, and that’s actually good enough for me in most cases.

Fraud would concern me, though. Can you tell me what appears fraudulent? Then I can focus on that. I don’t have as much time online this week as I’d like, due to several deadlines coming together at once.

BTW, random observation about pertussis….

Nobody in my family has ever had it. However, the neighbor’s dog had the canine equivalent, which is caused by a related pathogen, Bordatella bronchiseptica. We immediately had our dog vaccinated against it, and later use of boarding kennels exposed us to the knowledge that bordatella vaccine in dogs is recommended much more frequently than pertussis vaccine is in humans — annually, and in fact some recommend vaccination every 6 months. I suspect this is excessive; the legal context is a bit different with dogs than humans, and that changes things. But it makes me wonder if we aren’t taking Bordetalla pertussis seriously enough. Certainly our current course is not going to eliminate it; adults end up being unwitting reservoirs.

Callie, well one thing that comes to mind re. Fraud is Fombonne’s use of prevalence data in one city (Montreal) and matching results to vaccine uptake in another city (Quebec). I still find it pretty disturbing that an Autism Science”foundation would offer up as proof (of no reason to be concerned about vaccines and autism) such weak, and yes, misleading studies. I hope you do have a look at the whole article.

@ Jen:

I would love to see you answer the question.

But the details of individual studies matter not a whit in this case. It is incontrovertible that the rate of autism has not plummeted since thimerosal was removed from almost all vaccines. That’s as close as you can get to absolutely conclusive proof that thimerosal in vaccines does not cause autism. Disputes about details like Montreal vs. Quebec are nowhere near sufficiently impactful to make a material difference.

Calli Arcale:

About people with pertussis vaccine later catching pertussis — I rather suspect immunity is short-lived.

The same goes for actually catching pertussis. The immunity from the actual disease only lasts between five to twenty years (depending on the person), so why expect the vaccine to provide better immunity?

@Jen 119
Do you use a different definition of fraud to the rest of us?

You have every right to express an opinion critical of any scientific study – you don’t like Fommbone’s methodology in one of his studies, fair enough – criticise it if you can, explaining why not what the effect of the error will be on the results.

But to label it “fraud”, because you disagree with his methods and analysis?

PS If you care to respond to this post, I’d also like you to confirm whether on your opinion, Wakefield was fraudulent or not.
(Simple yes or no will do, ….shouldn’t take up more than a second of your valuable time)

Dt- I think there should be a comma in your question?” … If you can, explaining why not what the effect of the error will be…”
Quick answer, I don’t think Wakefield was fraudulent- I don’t think he falsified facts in the original report (altered clinical findings). He states that he has documents posted as to that.
As for Fombonne’s research I will leave it to Cochrane who found it very problematic.

Hmm…well, my first thought is that a bad study is not necessarily a fraudulent one. The word “fraud” is a very serious one with a very specific meaning. It refers not to mere incompetence or everyday human screwups but to intentional faking or alteration of data.

I’m not sure it’s convincing to say that Wakefield didn’t lie because he says he didn’t (which is what it amounts to when you say that he states he has documents posted to that effect). If he’s accused of fraud, you cannot simply take his word and evidence under his control to test the accusation.

Also, he was never accused of altering clinical findings. He was accused of reporting things in the study which did not match the clinical findings. There appears to be a significant and systematic set of discrepancies, all favoring his hypothesis, which are hard to explain as anything other than him adjusting the way he was reporting his findings and in some cases fabricating the findings altogether. I think he did commit fraud. Hewitson’s monkey study, by contrast, was not fraud but was instead incompetence. (Those findings appear to have been legitimate; it’s the interpretation which I think was bollocks, and that’s a different kettle of fish entirely.)

So proving Wakefield didn’t alter clinical findings doesn’t exonerate him of the charge of fraud.

“So proving Wakefield didn’t alter clinical findings doesn’t exonerate him of the charge of fraud.”

Wakefield,Deer,A mother of the Lancet 12..and others on The Gary Null broadcast from NY yesterday…pretty straight forward..the only fraud is Deer and vaccines…AND WHEN DEER AND THE BMJ WILL NOT,DEFEND THEMSELVES IT JUST ADDS TO THE FRAUD..

http://www.progressiveradionetwork.com/the-gary-null-show-wnye/

Sorry, OQF, but the facts are on the side of Deer and the BMJ. What does it matter that Wakefield shows up on biased programs like Null’s and claims he did nothing dishonest? The facts prove otherwise.

Here is another poor parent from The Lanct 12 showing her disgust of Deer..Deer the only being on the planet to complain about Wakefield..just hits, the BMJ article and runs, ..cant defend it nor will he ..he`s been told to belt up!!by Pharma..

http://www.garynull.com/home/julia-ahier-of-the-lancet-12-speaks-out.html

Friday
Jan282011
Julia Ahier of the Lancet 12 speaks out!
January 28, 2011

We wanted to share this message from Julia Ahier, one of the “Lancet 12” parents whos child was treated by Dr. Andrew Wakefield.- Gary

“I am absolutely convinced that the MMR triggered my Son’s condition, as the first problems with pain occurred on the first evening after the vaccination and the loss of skills happened after also he had been gaining weight at a good rate and after the MMR he only gained 1lb 7ozs in 9 months.

“I think that Dr Wakefield has only tried to help these children he has not done anything which we as parents did not want him to do. The allegations were unjust because they did not arise from anyone who had medical investigations carried out on them or their parents.

“Doctor Wakefield did not recruit anyone into the study group. In our case our Son was given the original referral to Professor Walker-Smith by another hospital and I sought a referral with Dr Wakefield our local paediatrician requested the referral.

“Dr Wakefield was the kindest most compassionate doctor who had ever taken an interest in our child’s case. He did not perform any proceedures on our child, these were dione with our consent and agreement by other doctors. None of the tests which were performed on our child were against our wishes. There was no display of callous behaviour.

I have never had any communication with Brian Deer nor do I ever intend to.”

Here is another poor parent from The Lanct 12 showing her disgust of Deer..Deer the only being on the planet to complain about Wakefield..just hits, the BMJ article and runs, ..cant defend it nor will he ..he`s been told to belt up!!by Pharma..

http://www.garynull.com/home/julia-ahier-of-the-lancet-12-speaks-out.html

Friday
Jan282011
Julia Ahier of the Lancet 12 speaks out!
January 28, 2011

We wanted to share this message from Julia Ahier, one of the “Lancet 12” parents whos child was treated by Dr. Andrew Wakefield.- Gary

“I am absolutely convinced that the MMR triggered my Son’s condition, as the first problems with pain occurred on the first evening after the vaccination and the loss of skills happened after also he had been gaining weight at a good rate and after the MMR he only gained 1lb 7ozs in 9 months.

“I think that Dr Wakefield has only tried to help these children he has not done anything which we as parents did not want him to do. The allegations were unjust because they did not arise from anyone who had medical investigations carried out on them or their parents.

“Doctor Wakefield did not recruit anyone into the study group. In our case our Son was given the original referral to Professor Walker-Smith by another hospital and I sought a referral with Dr Wakefield our local paediatrician requested the referral.

“Dr Wakefield was the kindest most compassionate doctor who had ever taken an interest in our child’s case. He did not perform any proceedures on our child, these were dione with our consent and agreement by other doctors. None of the tests which were performed on our child were against our wishes. There was no display of callous behaviour.

I have never had any communication with Brian Deer nor do I ever intend to.”

“So proving Wakefield didn’t alter clinical findings doesn’t exonerate him of the charge of fraud”

This evidence, refutes the accusations of fraud leveled against Dr Andrew Wakefield by the B M J,and Deer. This evidence was made available to the BMJ before the publication of their accusations, but they chose to ignore it. Go to link below and title/pdf NO FRAUD, NO HOAX. Here’sProof ,

http://vaccinesafetyfirst.com/Home.html

OQF/AWOL, I see you are pushing that silly website again, the one you offered when asked for a UK based source. So exactly what part of the UK is California?

Also, OQF/AWOL, if you try to explain what actual paper on that site actually replicates Wakefield’s finding, remember it has to be:

1: One that is independent. Neither Wakefield nor Krigsman can be an author, that pretty much wipes out much of the first page.

2: They have to be actual published papers, no poster presentations. That knocks out a few more.

3: They must be on children, and not adults. That knocks out a few more.

4: They should at minimum include a dozen case studies. The rejects several more.

5: Which MMR vaccine should be mentioned, and at the minimum should be either one used in the UK before and after 1992. There goes the Japanese study, and all of the others with no mention of measles at all.

6: Should not be a newspaper article. Especially the over four year old Daily Fail article you tried over at LBRB. Of course that also failed by being just a poster presentation, not a published paper.

7: And the word “replicate” means to get the same results, so you really need to explain why Measles, Mumps, and Rubella Vaccination and Bowel Problems or Developmental Regression in Children with Autism: Population Study replicates Wakefield when the conclusion clearly states:

These findings provide no support for an MMR associated “new variant” form of autism with developmental regression and bowel problems, and further evidence against involvement of MMR vaccine in the initiation of autism.

It will be amusing to see how you avoid answering the question, again.

Chris,

You have lost me with this one. My post above has nothing to do with association of mmr and whatever your going on about.

Very clearly its about a very BIG bit, of evidence that Brian Deer never passed onto the GMC or the BMJ and particularly onto Harvey Marcovitch.(Deer’s really stitched PATSY HARRY UP!

You seem to have a problem ,copied from the site above in pdf under the heading i gave you..see below

As for the rest of your rant ..In the real world, the conditions you apply for the replication of Wakefield’s finding`s this simply can’t happen – it is impossible. In order to compute your request with your conditions applied, you have to make assumptions that do not reflect reality as most studies would be about children,adults human beings,and sometimes chimps,rats and goats..(suprised you never detailed them in as well? duh!!)

Oh look its a pig flying past the window or was it swine flu?whats the random probability of that one Chris without your conditions applied?…more likely than what your requesting..

Messiah Brian Deer could tell us why he never included JWS paper below when he wrote up his reams of articles and passed them onto the GMC??? or the BMJ and particularly Patsy Harvey Marcovitch ..Why is it? the GMC and the BMJ are not interested in this information??

Read more:

DR. ANDREW WAKEFIELD WAS RIGHT. BRIAN DEER IS THE LIAR.
THERE WAS NO FRAUD. NO HOAX. HERE’S PROOF.
Parent from THE LANCET case series also complains to BMJ about Deer lies
STATEMENT FROM DR. ANDREW WAKEFIELD
I am accused of altering the clinical histories and test results in autistic children in
order to manufacture a disease – a disease described in The Lancet in 1998 that Brian
Deer says does not exist.
I have documents that confirm beyond a shadow of a doubt that I did not falsify the
data, that the findings are real, and that these findings were accurately reported in the
Lancet.
CALL TO ACTION FROM THE BRITISH MEDICAL JOURNAL because:
• New document confirms that there was no fraud (see below)
• BMJ failed to check facts before making allegations
NEW DOCUMENTS REVEALED
New documents have come to light confirming our report of intestinal disease and
autistic regression following MMR vaccine published in the medical journal THE
LANCET in 1998, The documents prove that there was no fraud. They describe 7 of The
Lancet children, and were written by Professor John Walker-Smith in December 1996,
14 months before our team’s paper was published.
Professor John Walker-Smith prepared the documents as a report for a scientific
meeting based upon his own assessment of the children’s disorder, supported by the
study’s senior pathologist Dr. Dhillon. I was not involved in these assessments (see
Level 4, Walker-Smith’s sworn testimony). I am accused of altering the findings to
report disease where none existed and deceiving my colleagues in the process.
It has also been revealed that Dr. Godlee, the responsible editor at the British Medical
Journal that published the allegations, did not adequately check these facts – facts that
were referred to in both my book, Callous Disregard: Autism and Vaccines – The Truth
Behind a Tragedy, published by Skyhorse Publishing in May 2010, and my complaint
about Brian Deer to the UK’s Press Complaints Commission.
THE PROOF
I present evidence that completely negates the allegations that I committed scientific
fraud. Brian Deer and Dr. Godlee of the British Medical Journal (BMJ) knew or should
have known about the facts set out below before publishing their false allegations1.
On December 20th 1996 a meeting was held at the Wellcome Trust in London. This
meeting was an annual gathering of doctors and scientists either collaborating with or
guests of my group, The Inflammatory Bowel Disease Study Group, based at the Royal
Free Hospital Medical School. For the purpose of this meeting Professor Walker-Smith
prepared a presentation on our initial experience of children with developmental
disorder and gastrointestinal symptoms – children who were to become part of THE
LANCET 1998 paper. Professor Walker-Smith did so on the basis of his own detailed
review of the endoscopic and microscopic findings2 in the intestinal biopsies. The title
of his presentation was:
Entero-colitis and Disintegrative Disorder Following MMR
A Review of the First Seven Cases
His notes of the presentation3 continued:
“I wish today, to present some preliminary details concerning seven
children, all boys, who appear to have entero-colitis and disintegrative
disorder, probably autism, following MMR. I shall now briefly present
their case history [sic].”
Professor Walker-Smith then set out, for each child, the details from the clinical history
obtained by him and his medical team (of which I was not part) and the results of his
own review of the tissue findings supplemented by those of Dr. Amar Dhillon, the
senior pathologist involved in the investigation of this syndrome. The relevant
behavioral and intestinal pathology findings were documented by him and are set out
below for each of the seven children.
2
1 Footnote 73 in “Deer”. Callous Disregard: Autism and Vaccines – The Truth Behind a Tragedy. 2010. New York.
Skyhorse Publishing. p.220. and Complaint against Brian Deer to UK’s Press Complaints Commission (pending).
2 All intestinal biopsy tissues went through three rounds of microscopic review: the first from the duty non-specialist
histopathologist, the second by Professor Walker-Smith and his team, and the third – a blinded review – by Dr Amar
Dhillon, the senior pathologist with expertise in intestinal diseases. (Statement of Dr. A.P. Dhillon to the GMC
lawyers, footnote 14. p. 214 and p. 199-203 Callous Disregard: Autism and Vaccines – The Truth Behind a Tragedy.
2010. New York. Skyhorse Publishing, and Complaint against Brian Deer to UK’s Press Complaints Commission
(pending).
Callous Disregard: Autism and Vaccines – The Truth Behind a Tragedy. 2010. New York. Skyhorse Publishing. pp
199-203 and Complaint against Brian Deer to UK’s Press Complaints Commission (pending).
3 Vaccinesafetyfirst.com. This document was supplied to me by Professor Walker-Smith in advance of the meeting
in 1996 and is the only copy he provided to me.

So, you don’t worry about English libel laws? Interesting.

I was asking about a specific link on that webpage, not the one you clumsily cut and pasted from. The one with the list of replications. Obviously, if Wakefield did not make it all up there would be one legit independent replication. Which one is it? Obviously not the one that says (cut and pasted from your clumsy cut and paste) “Entero-colitis and Disintegrative Disorder Following MMR” does not exist.

Messiah Brian Deer could tell us why he never included JWS paper below when he wrote up his reams of articles and passed them onto the GMC??? or the BMJ and particularly Patsy Harvey Marcovitch ..Why is it? the GMC and the BMJ are not interested in this information??

Why would Brian Deer think that “JWS paper” or anything else you reference in your word salad was relevant to Wakefield’s case, when Wakefield did not? Are you forgetting that Wakefield did not present any of those papers to the GMC hearing, even though it would have been far more his place and his responsibility than Brian Deer’s to do so?

Or do you think that “Messiah Andrew Wakefield” is such a special and perfect person that when he’s facing charges, he shouldn’t even have to present his own defense, the way every other person on the planet would be expected to?

@133

And once again, in all that wall of text, oqf provides nary a shred of evidence for his/her/its views.

Hardly surprising at all.

What is sad is he cut and pasted if from the website, his own words at the top are “My post above has nothing to do with association of mmr and whatever your going on about.”

So if it is not on the MMR, why did he cut and paste stuff on the MMR?

Antaeus Feldspar

From the same site I list above ..

BMJ/Deer Allegation One:
Dr. Wakefield altered clinical findings in the LANCET case series to report bowel disease in the
children where none existed
Dr. Wakefield’s response:
The findings reported in the LANCET case series reflect exactly what Professor
John Walker-Smith recorded in his notes for a scientific meeting 14 months before the case
series was published (see Walker-Smith document). The clinical assessments of these 7
children were Professor Walker-Smiths (not Dr. Wakefield’s); the findings were supported
by senior pathologist Dr. Dhillon; and they match exactly what was published in the
LANCET. This document confirms beyond doubt that Dr. Wakefield committed no fraud.
No histories were altered for the LANCET case series, and this document proves that.
In the BMJ, Deer provided a table comparing what he had found in the General
Practitioner’s (GP) records and what was reported in The LANCET paper. He cited
inconsistencies as evidence of fraud. First, the GP records (other than a referral letter to
the Pediatric Gastroenterology team) were not available to doctors who wrote The
LANCET paper, so fraudulent misrepresentation was not possible. Second, Deer used
wrong or incomplete information from the GP records in order to create the impressi

Read more from the site:

Chris,

” Obviously, if Wakefield did not make it all up there would be one legit independent replication.”

The smoking-gun evidence
Professor Walker-Smith’s 1996 presentation at the Royal Free Hospital Medical School was entitled, “Entero-colitis and Disintegrative Disorder Following MMR – A Review of the First Seven Cases.”

His presentation notes began with the following text: “”I wish today, to present some preliminary details concerning seven children, all boys, who appear to have entero-colitis and disintegrative disorder, probably autism, following MMR. I shall now briefly present
their case history [sic].”

He then went on to detail the clinical history of these seven children as derived from his medical team as well as senior pathologist Dr Amar Dhillon. Importantly, Dr Andrew Wakefield was not part of this investigation. This means that Dr Wakefield’s findings were independently replicated by another medical research team.

The British Medical Journal’s accusations against Dr Wakefield — that he fabricated his findings — are therefore false. The mainstream media accusation that Dr Wakefield’s findings have “never been replicated” is also blatantly false.

Here are the notes on the seven children, as presented in 1996, 14 months BEFORE Dr Wakefield published his landmark paper in The Lancet:

Child 1. Immediate reaction to MMR with fever at 1 [corrected, illegible]
Rapid deterioration in behaviour – autism
Histology active chronic inflammation in caecum
Treated Asacol
INDETERMINATE COLITIS** (1)

Child 2. MMR at 15 months – head banging 2 weeks later.
Hyperactive from 18 months.
Endoscopy – aphthoid ulcer at hepatic flexure
Caecum: lymphoid nodular hyperplasia with erythematous rim and pale swollen
core.
Histology, Ileum mild inflammation, colon moderate inflammation
Acute and chronic inflammation.
Treated CT3211 [a dietary treatment]
INDETERMINATE COLITIS** ? CROHN’S DISEASE

Child 3. ? dysmorphism – chromosomes and normal development
MMR at 5 months [sic]
Measles at 2.5 years* – 1 month later change in behavior
Hyperactive with food
Colonoscopy – granular rectum, normal colon and lymphoid nodular
hyperplasia.
Histopathology: lymphoid nodular hyperplasia.
Increased eosinophils 5/5 mild increase in inflammatory cells (Dhillon)
Routine normal
LYMPHOID NODULAR HYPERPLASIA
INDETERMINATE COLITIS**
[* correction: he received measles vaccine first at approximately 15 months of
age and MMR at 2.5. years]

Child 4 (2). Reacted to triple vaccine 4 months – screaming and near cot death
(DPT)
MMR at 15 months – behaviour changed after 1 week.
“measles rash” week before
Endoscopy – minor abnormalities of vascular pattern
Histology – non-specific proctocolitis**
Treated
INDETERMINTE PROCTOCOLITIS
LYMPHOID NODULAR HYPERPLASIA

Child 5 (3). MMR at 14 months.
Second day after, fever and rash, bangs head and behaviour abnormal
thereafter.
Endoscopy – Lymphoid nodular hyperplasia
Histopathology: Marked increase in IEL’s [intraepithelial lymphocytes] in ileum
with chronic inflammatory cells in reactive follicles. Increase in inflammatory cells in colon and IELs increased.
LYMPHOID NODULAR HYPERPLASIA
INDETERMINATE COLITIS

Child 6(7). MMR – 16 months – no obvious reaction
2 years behavioral change – 2.5 years
Screaming attacks – / food related
Endoscopy – Lymphoid nodular hyperplasia terminal ileum
Histology – Prominent lymphoid follicles
Dhillon: moderate to marked increase in IEL’s, increase in chronic inflammatory
cells throughout the colon – superficial macrophages not quite granuloma
INDTERMINATE COLITIS
Child 78. MMR 14 months
16 months “growling voice”
18 months – behavioural changes – autism diagnosed at 3 years
Barium [follow through X ray] 5 cm tight stricture [proximal] to insertion of
terminal ileum
Endoscopy- prominent lymphoid follicle in ileum
Mild proctitis with granular mucosa
Histology
Ileum – reactive follicles
Colon – bifid forms, increased IEL’s
Slight increase in inflammatory cells
INDETERMINATE COLITIS
? CROHN’S DISEASE

NOTES:
(1) Inflammation that is not diagnostic of either Crohn’s disease or ulcerative colitis
(2) Child 6 in The Lancet paper. The chronological order was corrected for the final Lancet paper.
(3) Child 3 in The Lancet paper

BMJ caught in its own fraud
These documents reveal that the British Medical Journal has been caught in its own fraud for willfully ignoring this evidence, which was presented to it long before its recent publication of Brian Deer’s article calling Dr Wakefield a fraud.

The BMJ willfully ignored this evidence and simply decided to destroy Dr Wakefield’s professional reputation by any means necessary. As Dr Wakefield explains:

“In allowing itself to become the vehicle for Brian Deer’s particular brand of journalism; in circumventing the process of due diligence in its enthusiasm to “kill the beast”, the BMJ has taken a huge risk. As the document presented above shows, this was a mistake. Medicine, presented with the possibility of an iatrogenic catastrophe, has boarded a dissonant bandwagon and has gone after those who have concerns – genuine concerns – that childhood vaccines may be responsible, at least in part, for the autism epidemic. The relevant science has been grossly misrepresented, crushed beneath the wheels of a Public Relations 16-wheeler that is out of control. In the meantime a relentless tsunami of damaged children claims this land.”

Brian Deer caught as a liar
It has also been revealed that journalist Brian Deer, the author of the BMJ article condemning Dr Wakefield as a fraud, is himself a liar. In attempting to gather evidence for his article in the BMJ, he lied about his identity and entered the home of one of the parents of the autism children. Specifically, he claimed he was working for The Sunday Times even though he was never a Sunday Times employee.

This is just the tip of the iceberg of the outright deception that has been used by the BMJ and Brian Deer in their attempt to silence a doctor whose only “crime” was publicly expressing concern about the safety of MMR vaccines.

That the BMJ and its writer Brian Deer have now been caught ignoring evidence and engaging in their own fraud gives credence to the idea that MMR vaccines may, indeed, not only be dangerous; but that they may be so dangerous that the top medical journals have to lie about the facts in order to protect them.

What’s clear here is that the BMJ has strayed so far from the realm of evidence-based scientific thinking that it can no longer be called a reputable medical journal at all. Its callous disregard for the truth — and its politically-motivated witch hunt against a researcher who only sought to protect the health of children — exposes it as a danger to the scientific community and the world of conventional medicine.

As this truth unfolds, these revelations will rock the medical world and expose these science journals as the frauds they truly are. Think about this: While these medical journals are taking money from vaccine manufacturers (who pay their ads), they are ignoring any scientific evidence they don’t like in order to vilify anyone who threatens the profits of these very same vaccine companies! And yet, these medical journals never admit that their very existence depends on the financial flow of money from these vaccine manufacturers who are strongly impacted by their editorial decisions!

There is fraud taking place in the vaccine industry today, of course, and the medical journals are the point men who push their distorted disinformation into the minds of doctors, journalists and anyone they can reach with their scientific distortions. At stake is the future of the vaccine industry, which is of course a multi-billion-dollar industry that thrives on misinformation and the ongoing scientific censorship of the facts surrounding the health risks posed by vaccines.

Of course Mr Deer could come on here and put the record straight..mind you he would have to tell the truth to do that …wont hold my breath…

Stop cutting and pasting from that silly website and answer the question. Which of the papers in the list on that silly website actually replicates Wakefield’s findings with the criteria I laid out on the independence, number of and type of case studies and which MMR vaccine?

Failure to answer the question will reveal that you have no clue, are a troll and will be ignored.

Chris its obvious you dont read posts .Fine to copy and paste if your a Pharma troll though Chris?is`nt it…As I said below..off you go and grow up..

“As for the rest of your rant ..In the real world, the conditions you apply for the replication of Wakefield’s finding`s this simply can’t happen – it is impossible. In order to compute your request with your conditions applied, you have to make assumptions that do not reflect reality as most studies would be about children,adults human beings,and sometimes chimps,rats and goats..(suprised you never detailed them in as well? duh!!)”

OQF/AWOL, all you had to do was answer the simple question of which of the papers listed on that website actually independently replicated Wakefield’s findings. If you had done so you would have indicated you read and understood the papers, proven your point quite adequately, successfully defended Wakefield and shown you have more than two brain cells to rub together.

But you failed miserably. Now go back under your bridge.

Chris,better having two brain cells, than none at all..duh!!

Novalox ,a true pharma troll …

Now you’ve just gone to nonsensical insults. You seem to believe truth and falsehood depend on the one making the statement, and that we share the same belief. The problem is, we don’t believe Deer because we think he’s honest, we believe him because the evidence matches up to his claims. Likewise, we don’t automatically believe the list of studies you keep posting, because the claims made grossly contradict the actual contents of the papers.

You know Gray Falcon your post reminds me of Lewis Carroll Alice’s Adventures in Wonderland and Through the Looking Glass and What Alice Found There, nonsense is used to illustrate the absurdities of civilized life.

The paradox of your post is , we dont believe Deer but his evidence matches up..??how the hell??

And you dont want to believe me, because I can contradict Deer ,does that make you right??

Strange …

I am, have arrived in Pharma land for sure..

Actually, you not answering which of the studies listed on the website truly independently replicates Wakefield’s findings is admitting that they are figments of his imagination. So there you go. It has nothing to do with Deer, the data have shown that Wakefield is a fraud.

Brent Taylor showed Wakefield was wrong in 1999 and 2002. That was years before Deer was on the scene. So swim back under your bridge little fishy troll.

The paradox of your post is , we dont believe Deer but his evidence matches up..??how the hell??

That’s because you misread my sentence (which didn’t really parse well). Let me try again: The reason we trust Deer is not simply because we think he’s honest, we believe him because the evidence matches up to his claims. Several people, including former anti-vaccinationists, have done the research, and were able to independently back up his claims.

And you dont want to believe me, because I can contradict Deer ,does that make you right??

No, I don’t believe you because your statements contradict the evidence. You’re not really used to dealing with evidence, are you? You keep thinking this is about Brian Deer, but it isn’t. It’s about evidence.

Chris,(humpty) and Gray Falcon(dumpty)

Your ad- hom. .isn’t worth answering..

I take great heart, in the manner in which you both, try to distance Deer from all that is going on the BMJ,GMC, evidence?. Deer from the start, has been the epicentre of the whole controversy remember his “it woz me that did that” ,he has claimed every inch of the MMR –Autism ,controversy and as the outer winds got bigger and stronger , he has claimed the whole lot.

Just to say interesting why you are all trying to distance Deer now… how does that poem go ..Humpty Dumpty …FALL??

Have you graduated from grammar school yet? Do you know how to count? If so, try these arithmetic questions:

So, how many of these are written by Deer?:
http://www.immunize.org/journalarticles/conc_mmrarchive.asp

And, how many of these are written by Deer?:
http://www.immunize.org/journalarticles/conc_mmr.asp

Now add up all of the ones you counted on both pages, and then find out what the percentage of those were written by Deer (ask a grown-up how to do that). Come back next week after you finish that.

The question is,” said Humpty Dumpty, which is to be master-that’s all.

Seems you no longer wish Deer to be master- Chris??mmm..

Seems you no longer wish Deer to be master- Chris??mmm..

We never did in the first place. Your assuming we looked to Deer like a messiah was simply projecting your own views on Wakefield onto us. We were looking at the evidence, nothing less.

You, on the other hand, simply accept whatever Wakefield tells you. For example, if you read the abstracts of the studies you posted, you’d have noticed most of them did not support Wakefield’s claims. Likewise, if you clicked on Chris’ links, you would have noticed Brian Deer was only a recent comer into this, despite your bizarre claims.

Little fishy troll, like Gray Falcon said: I have tried to direct you to the evidence. The point of my questions was to get you to look at the papers and actually read them. The point of the last two links was to show you that Deer was not the only person looking at the data.

But you seem incapable of reading, counting or even thinking for yourself.

Here is the summary: Wakefield’s data has always been considered dodgy. He burst out with a video press release telling parents to not use a vaccine that had been safely used for almost twenty years in other countries. He did not evidence for that.

We all knew Wakefield was wrong for over ten years.

Deer just provided the reason he was wrong. It was because Wakefield lied.

It`s a funny old world innit?

Deer had planned from the outset to get Wakefield before the GMC on charges. Before a single word had been written by Messiah Deer had consulted with and been given free advice and assistance by Association of the British Pharmaceutical Industry company Medico-Legal Investigations Limited, whose speciality was getting doctors on charges before the GMC and which co-directors of its board from the ABPI

published English High Court judgement of Justice Eady below

2. The background to the litigation is the long standing controversy surrounding the MMR vaccine. The Claimant is a gastroenterologist. The first Defendant (‘Channel 4′) is a broadcasting corporation, which broadcast on 18 November 2004 a programme which forms the subject-matter of these proceedings, and which was produced by the second Defendant and presented by the third Defendant (‘Mr Deer‘). ‘‘.

3. Well before the programme was broadcast Mr Deer had made a complaint to the GMC about the Claimant. His communications were made on 25 February, 12 March and 1 July 2004 ‘. it seems likely that a hearing will take place commencing in July 2007 and lasting for many weeks.

Okay, dude, you just made a claim that Deer planned this from the outset. It is up to you prove he even knew about it in 1999, the date of the earlier paper I linked to above.

Or are you just insanely illiterate?

Chris you wouldn`t put words in my gob would you..”Outset” meaning in fact, Deer was originally funded to investigate Andy by a front group for the Association of the British Pharmaceutical Industries, just as Andy Wakefield said. From a confidential source:

“Deer was provided with free assistance by Medico-Legal Investigations a company owned and controlled by the Association of the British Pharmaceutical Industry – I have documentation on this. MLI specialise in getting medical doctors prosecuted by the General Medical Council. And that was done before he published in The Sunday Times in Feb 2004.”

Cant make it up??

That’s a quote without a source, and a series of accusations without evidence. For one thing, you’re claiming an independent organization (Medico-Legal Investigations) is in fact, owned by the Association of the British Pharmaceutical Industry. So where’s the documentation?

Show the documentation that Deer planned this starting in 1999, which coincides with Dr. Taylor’s paper linked above. You said Deer planned it on the outset. Well, that was when the wheels were already spinning in 1999 showing that Wakefield was wrong.

Show the evidence, or it will be assumed you are making it all up.

Well, this one’s a case, and no mistake. There’s a mononotion at work, a mania, which he repeats ad nauseum, and way beyond….Brian Deer….Brian Deer…messiah….Pharma shill…troll…Brian Deer…Nature News….

Failure to answer the question will reveal that you have no clue, are a troll and will be ignored.

Chris I have the greatest of respect for your knowledge, wit, and patience, but I would have thought that your one stop challenge for this odious wanker is strictly unnecessary – he hasn’t said anything beyond Gumby-like nonsense in any of his posts, and his delusion that we are all paid apologists for some hideous global conspiracy to harm children is beyond contempt.
Then again, the patient, courteous, knowledgeable contributors to this blog – such as you – will clearly show anyone reading who the idiots and trolls here are, and by implication how stupid their “ideas” are.
No criticism then, to you or anyone else who slave to counter bad thinking and an absence of knowledge, just a faint regret that all your efforts have not stopped this particularly ignorant, and insufferably prolix moron from vomiting so much stupidity over “respectful insolence.”
OQF – unemployed?
Please, let it be so….

I guess you are right, AnthonyK. I have laid out the information for anyone to figure out what I tried to get the little fishy to read.

It was Professor Sir David Hull in 1998 who, as chairman of the Joint Committee on Vaccination and Immunisation, started the attacks on Wakefield’s work. The Joint Committee on Vaccination and Immunisation advises the Department of Health on vaccination issues and the childhood vaccination programme. As Chairman of the JCVI, Professor Sir David Hull could have taken action to deal with the issues over the MMR and protect British children. Despite his attacks on Wakefield’s work, allleging unethical research on children for no clinical benefit, two years later in 2000, it was Professor Sir David Hull who rewrote the Royal College of Paediatrics and Child Health ethical guidelines to permit research on children where there was no clinical benefit (albeit in The Royal Free’s case all the investigations were clinically justified).

More guys ,getting to the toe curling bit ..

The Sunday Times’ freelancer was assisted in his efforts with free advice and assistance from the Association of British Pharmaceutical Industry funded and controlled company Medico Legal Investigations Limited. Medico Legal Investigations Limited speciality was in getting medical doctors on charges before the General Medical Council. So we know that before a single word was published by The Sunday Times, it was already being planned with the involvement of interested parties that Wakefield and colleagues were to be taken before the GMC.
Another free of charge helper to Sunday Times journalist Deer was Glaxo Wellcome funded Fellow and active British Medical Association member, Dr Evan Harris MP. Harris has advised and assisted Deer up to the present, including attending the Wakefield GMC hearings with Deer.

The Sunday Times journalist, Deer, was also assisted by The Royal Free’s Strategic Health Authority which passed Deer confidential documents ‘in the spirit of openness’ and including documents relating to the confidential medical treatment of the MMR child litigants. The SHA at first denied providing documents until it was pointed out the fact was disclosed by Dr Evan Harris MP, in Parliament on 15th March 2004.

gets worse…

On Saturday 21 February 2004, Lancet Editor Richard Horton pre-empted the Sunday Times stories. Horton was reported in The Times claiming he would not have published the MMR part of The Royal Free’s Lancet paper had Wakefield’s paid involvement in the MMR litigation been disclosed. The Sunday Times had waited until Sunday 22 February 2004, 5 days before judgment in the MMR child litigants’ High Court challenge to the withdrawal of legal aid, to publish its stories attacking Wakefield. Prime Minister Blair was reported in the press on the issue as was Health Secretary Reid.

Legal aid was withdrawn on 27th February 2004 in a secret judgment by High Court Judge Nigel Davis. The reasons remain unpublished today. Evidence given in open court at a different hearing included the allegation from a parent that an official admitted to her that legal aid was withdrawn after government pressure.

It was discovered in 2007 that Judge Sir Nigel Davis is the brother of Lancet owner’s CEO and main Glaxo board member Sir Crispin Davis. When challenged a statement was issued on Judge Davis behalf to The Telegraph newspaper’s legal correspondent Joshua Rosenberg and stated “The possibility of any conflict of interest arising from his brother’s position did not occur to him.“

On 15th March 2004 Dr Evan Harris launched an unprecedented and defamatory Parliamentary attack on Wakefield and his Royal Free colleagues and to which not one of Harris’ Liberal Democrat colleagues contributed. This was based on material in documents Sunday Times freelancer Deer had obtained and passed to Harris. Harris used the opportunity to raise allegations The Sunday Times chose not to publish.

Crispin Davis was awarded a knighthood June 2004.

“”Sunday Times freelance journalist Brian Deer confirmed it was he who had made the submissions to the GMC which led to the present GMC proceedings against Wakefield.””

Wakefield’s lawyers had reported in November 2004 that Deer had made a statutory complaint to the GMC and freelancer Deer reported in the Sunday Times in December 2004 that the General Medical Council was investigating the complaints against Wakefield.

Proof that vaccines cause autism.

“Perception of morality different when you have autism”

http://www.msnbc.msn.com/id/41356408/ns/health-health_care/

All of the sciencebloggers are heavily vaccinated. Sciencebloggers have autistic tendencies. They always BLAME the UNvaccinated for everything.

But people with autism may perceive morality differently than normally functioning people because they focus more on the outcomes of situations

That’s why they always say “but the end justifies the means. I mean “the benefit outweighs the risk.”

Moral judgment is a complex social cognitive process, but it is also influenced by moral education, Young said.

…Or sciencebloggers are not autistic. They were just morally educated by nihilists.

Little Fishy Troll: how do we know you did not make that all up? There is no reference from where you cut and pasted that.

Same question as before: Any evidence for any of this? You’ve made several claims, and never backed up any of them, at all. Get this through your thick skull: We’re not going to believe you just because you think you’re such a nice guy, we need evidence for these claims.

Gray Falcon, it was a straight cut and paste from the childhealthsafety website, a place that has issues with honesty.

@Chris: Makes sense. At least augustine’s nice enough to cite his sources.

@augustine: Tell me, are you the sole arbiter of morality here?

All of the sciencebloggers are heavily vaccinated. Sciencebloggers have autistic tendencies. They always BLAME the UNvaccinated for everything.

It’s not called blame, it’s called evidence. The unvaccinated are responsible for the recent outbreaks, and we can show that.

That’s why they always say “but the end justifies the means. I mean “the benefit outweighs the risk.”

Those are two very different types of morality. Of course, your standard of morality seems to be “Look out for myself, society can go hang.”

OQF is a birther, isn’t he? If he’s not, I’m sure it’s only because he’s not from the US. He’s clearly perfected the necessary double standard, whereby every “official” source of information is automatically considered to be part of The Conspiracy — but of course, “some guy on the Internet who’s saying what I want to hear” has to be on the level.

We never argued that vaccination is 100% effective. For example, if the vaccine is about 90% effective and 95% of the population is vaccinated, then, working out the math, you get this pattern for an outbreak from a sample of 1000:

Unvaccinated: 50 people, 45 infected, 5 clear.
Vaccinated: 950 people, 95 infected, 895 clear.

That’s around 2 in 3 vaccinated infected, but the vaccine is still the clear choice. Also, it can be shown that outbreaks are less likely if the vaccine is widespread, since there are fewer places for it to start.

Look, if you’ve got a 100% effective solution that we don’t know about, we’d love to hear about it, but otherwise, you don’t have a point.

Gray Falcon

We never argued that vaccination is 100% effective. For example, if the vaccine is about 90% effective and 95% of the population is vaccinated….

You don’t know how many are unvaccinated. Therefore you’re missing a denominator. Among other things.

You don’t know how many are unvaccinated. Therefore you’re missing a denominator. Among other things.

That’s my line. You were missing the proportion vaccinated, and without that, your argument is meaningless. I was merely giving a hypothetical using a standard proportion for effectiveness that showed what was most likely happening, which was very different from what was happening in your mind. Your argument was meaningless without that number.

Try to think for once, not just react. It will save you quite a bit of effort.

172- You can’t be the real Chris. The real Chris would have gone into details as to why I was wrong. Or would have linked to something showing how many people were vaccinated. So who are you?

Gray Falcon, it was definitely not me, I had already turned off my computer. I believe he has been warned before to not sock puppet other commenters here.

I have a text file with my pertussis herd immunity numbers. Also, I know that even if a person gets the actual disease pertussis, their immunity does not last forever (it is between five to twenty years depending on individual codons). Here is my herd immunity arithmetic:

Take 1000 people (ignoring the infants under 2 months who cannot be vaccinated, or babies under a year who can only be partially vaccinated), if 5% refuse vaccines then the numbers are:

950 vaccinated persons (assuming full schedule)
50 unvaccinated persons

The pertussis vaccine is actually only 80% effective at worse, so the numbers are:

760 protected persons
190 vaccinated but vulnerable persons
50 unvaccinated persons

There is an outbreak and it gets spread to 20% of the population, then:

760 protected persons without pertussis

38 vaccinated persons get pertussis
152 vaccinated person who may still get pertussis

10 unvaccinated persons get pertussis
40 unvaccinated persons who may still get pertussis.

This is how more vaccinated persons get the disease than unvaccinated. Even if the infection rate was at 100%, there would still be more of the vaccinated getting the diseases because there are more of them!

Thanks for the hypothetical numbers, real Chris. Your example is much better than mine, really. I was only guessing that the fake Chris was a sockpuppet, but it seems I was right. I guess augustine didn’t like that his criticism applied mostly to his own argument.

Also, augustine, if you’re still listening: That whole “autistic=evil” rant at post 162 crossed the line, as did suggesting vaccination is immoral.

“Perception of morality different when you have autism”

http://www.msnbc.msn.com/id/41356408/ns/health-health_care/

All of the sciencebloggers are heavily vaccinated. Sciencebloggers have autistic tendencies. They always BLAME the UNvaccinated for everything.

It looks to me like autistics understand liability and responsibility quite well. If you misinform or disinform, you’re responsible — no question.

These types of studies are always interpreted with an anti-autistic bias.

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