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Alleged Misreporting of Data in Lancet Study Connecting Autism to Vaccine:

The Times (London) reports:

THE doctor who sparked the scare over the safety of the MMR vaccine for children changed and misreported results in his research, creating the appearance of a possible link with autism, a Sunday Times investigation has found....

The [original] research was published in February 1998 in an article in The Lancet medical journal. It claimed that the families of eight out of 12 children attending a routine clinic at the hospital had blamed MMR for their autism, and said that problems came on within days of the jab. The team also claimed to have discovered a new inflammatory bowel disease underlying the children's conditions.

However, our investigation, confirmed by evidence presented to the General Medical Council (GMC), reveals that: In most of the 12 cases, the children's ailments as described in The Lancet were different from their hospital and GP records. Although the research paper claimed that problems came on within days of the jab, in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated. Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal....

Thanks to InstaPundit.

UPDATE: By the way, I should note that if there was misreported data here, the failure was not a failure of "peer review" (at least as the term is, to my knowledge, generally understood). Peer review involves reviewers checking the written article to see if it has errors in its reasoning, or fails to consider important and already known contrary data or arguments, or is duplicative of preexisting research.

Peer review, as I understand it, generally doesn't involve source-checking the article to make sure that it accurately reports the underlying data. Law review cite-checking in some measure does that, but it's unusual as far as scholarly journals go (partly because it relies on the unpaid labor of student editors, who are common only in law; faculty editors and peer reviewers aren't willing to do this sort of thing). And I doubt that even cite-checking would usually go so far as to demand that the scholar provide the underlying medical charts on which the author based his data. Usually the tables from the author would suffice, especially if the author says -- accurately or not -- that the underlying charts aren't available (for instance, because of privacy concerns at the institution that maintains the charts).

To be sure, The Lancet and other such journals could institute systems in which all the underlying data is checked as much as possible, though even that can't catch certain kinds of errors (and especially certain kinds of deliberate falsifications). But it would require a tremendous amount of extra work. Perhaps some learned journals do invest this kind of work, but to my knowledge that is not and has not been the norm; much of academic publishing is built on trust of the authors, and even if some verification is done, it is not the sort of comprehensive verification that one does when one suspects that the data is badly wrong or even deliberately falsified.

EricPWJohnson (mail):
There are a host of problems with some Lancet studies coming to light

Yes of course the famous faux - totally made up - story of nearly 1 million dead in Iraq

But there are others coming in.

Whether its unjustified piling on by partisans so inflamed with the damage of the politically motivated Iraq report or perhaps real - time will tell
2.8.2009 10:53am
Sagar:
Did Sen. McCain have any comment in response to this?
2.8.2009 11:12am
bikeguy (mail):
Lying when the data don't match the agenda? Welcome to the new scientific method.

Pardon those of us who don't believe the breathless and non-skeptical reports of findings like this in the media. (See Global Warming)
2.8.2009 11:14am
Sarcastro (www):
This one guy lied to me once so I never beleive anything anyone says about anything anymore.
2.8.2009 11:22am
Scote (mail):

bikeguy (mail):
Pardon those of us who don't believe the breathless and non-skeptical reports of findings like this in the media. (See Global Warming)


Sorry, bikeguy, but this is an example of real scientists uncovering scientific fraud. It is an example of the triumph of science, of facts over fiction and an example of science working the way it is meant to. In the analogy, Wakefield (the fraud) would be akin to the climate deniers, not the other way around.

Like some climate deniers, Wakefield was in cahoots with a monied partner with a vested interest in the outcome. Wakefield worked with lawyer "Richard Barr seeking to sue vaccine manufacturers for "vaccine-induced" autism before he undertook his research."

Today, Wakefield enjoys a cultlike following of desperate parents who want something sound to blame their children's tragic autism on, and the fact that Wakefield is a fraud and opportunistic scum, IMO, will never sink in.

Wakefield, and the anti-vaccination hysteria he has helped create based on his fraudulent paper, have lead to the kinds of hysteria that kills people. He deserves to be prosecuted for the very real consequences of his deliberate fraud, in my oppinion.
2.8.2009 11:52am
Scote (mail):
Clarification:

The exposed scientific fraud Andrew Wakefield, who created a fraudulent study that falsely falsely claimed to have found a link between MMR vaccines and autism, worked with lawyer Richard Barr before creating his fraudulent study. Barr was a member of the anti-vaccine group Jabs and was seeking to sue vaccine makers even before Wakefield's study.
2.8.2009 12:05pm
Roger Schlafly (www):
Why devote so much energy to a 10-year-old study of only 12 cases? A huge number of medical studies have misleading conclusions. The best cure is usually to collect new data and do a new study.

The antagonism towards Wakefield is a little strange. If the vaccine is really safe, then let the vaccine promoters publish the evidence.
2.8.2009 12:06pm
Brian K (mail):
I'm just surprised it took 11 years for someone to look at the guys underlying data!
2.8.2009 12:09pm
Texas Lawyer:
I've never understood how people claiming vaccines caused autism could blame both MMR vaccines and the thimerosal (mercury) vaccines. It seemed odd that both could cause autism.

Thimerosal is a preservative, so it couldn't be used in live, attenuated vaccines like MMR. This means that MMR is (and always has been) mercury free. It seems that if both the mercury-containing and mercury-free caused autism (and, similarly, both the MMR and the non-MMR) then the problem was somewhere else.

This has always seemed a fundamental flaw in the vaccine/autism case. It always seemed to me that they violated the first rule of scientific experiments and never got their control right.
2.8.2009 12:11pm
Thoughtful (mail):
Prediction: This will have ZERO effect among those who believe there is a link between autism and vaccination.
2.8.2009 12:25pm
therut (mail):
His name was not Kellerman, or RFK, Jr. ?????
2.8.2009 12:29pm
Roger Schlafly (www):
Wakefield's paper was only about MMR, and not mercury.

Yes, Wakefield has a conflict of interest, but the chief proponents of MMR and other vaccines at the FDA and CDC have much worse conflicts of interests.
2.8.2009 12:29pm
Scote (mail):

Why devote so much energy to a 10-year-old study of only 12 cases? A huge number of medical studies have misleading conclusions. The best cure is usually to collect new data and do a new study


Well, for one thing, the very strong (and fraudulent) conclusions of the study are the primary data that have been used to support the anti-vaccine hysteria in the UK and the US. And multiple studies **have** been done. Wakefield's results are not replicable and large epidemiological studies have shown no correlation between Thimerosal or MMR vaccines and autism, but the hysteria has not abated. The new information that the original study was not just sloppy but an actual fraud completes the case against the fallacious link between MMR and autism: It never was and isn't now.


The antagonism towards Wakefield is a little strange. If the vaccine is really safe, then let the vaccine promoters publish the evidence.

The "antagonism towards Wakefield is a little strange"???? Wakefield created a fraudulent study that has lead to massive amounts of damage to the public health systems of the US and the UK, contributing heavily to baseless anti-vaccination hysteria and the reduction of vaccination rates and the rise of measles--all based on ***fraud***. Massive and expensive studies to counter the fraudulent study and disprove the findings, people are sick and the public is grossly miss informed because of this fraud artist and you find the antagonism towards him?????? What is strange is that you would try and defend him given the facts as they are now known.

Pro-public health forces **have** done studies that prove that there is no link between MMR and autism, but hysterical antivaccinationists aren't interested in evidence if it contradicts their pre-conceptions, instead they "know" they are right based on their feelings, their intuition, anecdotes, and the (fraudulent) study of their "hero" Andrew Wakefield. And they post to blogs like this one trying to suggest that it is hard to understand why a deliberate fraudulent study should be such a big deal...
2.8.2009 12:40pm
Eric Anondson (mail):
Why devote so much energy to a study of just 12 children? Another excerpt from the Times article:
<blockquote>Despite involving just a dozen children, the 1998 paper's impact was extraordinary. After its publication, rates of inoculation fell from 92% to below 80%. Populations acquire "herd immunity" from measles when more than 95% of people have been vaccinated.

Last week official figures showed that 1,348 confirmed cases of measles in England and Wales were reported last year, compared with 56 in 1998. Two children have died of the disease.</blockquote>Apart from contributing to distrust of vaccines generally, this man's fraudulent research has caused calculable misery and pain due to an increase in MMR.
2.8.2009 12:54pm
Roger Schlafly (www):
If Wakefield is wrong, then he can be proved wrong with scientific data and evidence. It does not matter what his motives were.

His study has not caused any harm. Measles has been eliminated from the USA, and it remains eliminated except for any occasional case that comes in from overseas. If his paper cases people look more seriously at vaccine safety, so much the better. The removal of thimerosal from vaccines was based on govt-declared limits on mercury intakes, and not on Wakefield. Are you suggesting that the mercury be put back in the vaccines?
2.8.2009 12:56pm
guest890:
Roger Schlafly:
Why devote so much energy to a 10-year-old study of only 12 cases? A huge number of medical studies have misleading conclusions. The best cure is usually to collect new data and do a new study.

The antagonism towards Wakefield is a little strange. If the vaccine is really safe, then let the vaccine promoters publish the evidence.

They have. Repeatedly. Many times, and with much larger sample sizes. (And technically, it's academics rather than "vaccine promoters" who do the publication--which gives me greater confidence in their results, government research grants notwithstanding. Real science is not a propaganda war. Junk science, on the other hand...)

See, for example, this 2005 meta-study of 139 previous studies. Or this survey of over 27000 Canadian children (which found that autism rates actually rose when vaccination rates declined). Or this study which tried specifically to test Wakefield's results.

Despite the overwhelming evidence, the anti-vaccine hysterics won't listen and continue to cling to the Wakefield study. Finding problems in the Wakefield study probably won't dissuade them either, but analyzing that study for errors was probably the right thing to do anyway given its high profile.
2.8.2009 1:11pm
Scote (mail):

Roger Schlafly (www):
If Wakefield is wrong, then he can be proved wrong with scientific data and evidence. It does not matter what his motives were.


His study has been proven wrong with evidence, through massive epidemiological studies necessitated by his fraud. But the hysteria has not been abated. Wakefield is still a popular figure in anti-vaccination / anti science circles. And, given that his study was **fraudulent** it does matter, because it means that there is no link to have to disprove.

Speaking of motives, your website is dedicated to "Debunking the Judicial Supremacists and the Leftist Evolutionists." Clearly you consider the battle against science to be an ideological one, given that the well established scientific theory of evolution through natural selection is not, in fact, a "leftist" theory, but a scientific one that has no ideological bent, unless you believe as Stephen Colbert said, that "reality has a well known liberal bias." So, should we be surprised by your vigorous defense of scientific fraud, Andrew Wakefield? Are you one of the ones who claims that MMR causes autism? Are you? Do you think that vaccines are a leftist plot, like evolution?
2.8.2009 1:12pm
dearieme:
"Peer review involves reviewers checking the written article to see if it has errors in its reasoning, or fails to consider important and already known contrary data or arguments, or is duplicative of preexisting research." Yes, but even those are secondary - I was taught long ago - to the reviewers' job of insisting on clarity and completeness. As long as the paper is clear and complete enough, the readers will find any errors.

(By the way, much of the Global Warming literature hopelessly fails the tests of clarity and completeness. That, it seems to me, is the real burden of complaint of Steve MacIntyre at Climate Audit.)
2.8.2009 1:17pm
bornyesterday (mail) (www):

Why devote so much energy to a study of just 12 children?


Because the attention given to this original study was overwhelming and it has been pointed to for the last 10 years as evidence that vaccines cause autism. As a result, the number of children who have not received vaccines for disease such as measles, mumps, rubella, chicken pox and other similar childhood viruses has been steadily increasing over the last 10 years. The growth of the number of measles cases has been especially noteworthy over the last 5 years. Now that this case has been proven fraudulent, all the educators and doctors and scientists and members of the general public who have been fighting against the anti-immunization crowd have more ammunition to show that there is no evidence of a connection between vaccinations and autism.


Yes, Wakefield has a conflict of interest, but the chief proponents of MMR and other vaccines at the FDA and CDC have much worse conflicts of interests.


Indeed. Like preventing widespread outbreaks of easily preventable and often deadly diseases.
2.8.2009 1:22pm
Erick:
Not sure why I'm even going to try and respond, but oh well.


If Wakefield is wrong, then he can be proved wrong with scientific data and evidence. It does not matter what his motives were.

Then why were you complaining about conflicts of interest of everyone who has done a study showing no link between autism and vaccines? Its just a few posts up.


His study has not caused any harm. Measles has been eliminated from the USA, and it remains eliminated except for any occasional case that comes in from overseas. If his paper cases people look more seriously at vaccine safety, so much the better. The removal of thimerosal from vaccines was based on govt-declared limits on mercury intakes, and not on Wakefield. Are you suggesting that the mercury be put back in the vaccines?

The occasional case from overseas which now spreads to children whose parents did not vaccinate them based on fraudulent data. Measles cases are rising every year, and its just going to get worse as more parents become skeptical about vacccines because of fraudulent research and enablers like you.

And Thimerosal is not merucry.
2.8.2009 1:52pm
CDU (mail) (www):
Sorry, bikeguy, but this is an example of real scientists uncovering scientific fraud. It is an example of the triumph of science, of facts over fiction and an example of science working the way it is meant to.


According to the article, the fact that Wakefield faked his data wasn't discovered by scientists, but by reporters from The Sunday Times.
2.8.2009 2:11pm
Scote (mail):

According to the article, the fact that Wakefield faked his data wasn't discovered by scientists, but by reporters from The Sunday Times.


Indeed, you are right. While scientists and massive epdemiological studies proved that there is no link between MMR and autism, it was the work of intrepid reporter Brian Deer who tenaciously covered this story. However, the fraud listed in the article was confirmed by evidence presented to an investigation by the General Medical Council. I oversimplified the situation in my post. Thanks for note.
2.8.2009 2:16pm
Fub:
And Thimerosal is not merucry.
Technically true, but misleading.
Thiomersal (INN) (C9H9HgNaO2S), or sodium ethylmercurithiosalicylate, commonly known in the United States as thimerosal, is an organomercury compound (approximately 49% mercury by weight) used as an antiseptic and antifungal agent.
I see no reason to be coy about such a fundamental fact: Thiomersal / Thimerosal is a compound of Hg. That has no bearing on whether Hg or any of its compounds cause autism or any other condition.
2.8.2009 2:21pm
Roger Schlafly (www):
Are you one of the ones who claims that MMR causes autism? Are you? Do you think that vaccines are a leftist plot, like evolution?
No, I do not claim that MMR causes autism. I doubt that thimerosal causes autism. I do think that mandatory vaccination is primarily promoted by leftists, and is unnecessary. I favor convincing people with scientific data. If MMR or thimerosal is such a good thing, then do the studies that show the merits, and inform the public. Wakefield only gets attention because the public health authorities are not doing their jobs properly.
2.8.2009 2:22pm
Chuck Jackson (mail):
FYI: The reporter's own web site.

http://briandeer.com/mmr-lancet.htm
2.8.2009 2:26pm
Scote (mail):

No, I do not claim that MMR causes autism. I doubt that thimerosal causes autism.


All I see you doing is playing the FUD game. "I do not claim that MMR causes autism." Well guess what. It doesn't. Massive studies have shown that there is no correlation. But you are still trying to leave open the disproved and falacious link Wakefield made.


I do think that mandatory vaccination is primarily promoted by leftists, and is unnecessary.


Mandatory vaccination is the only way vaccinations work effectively. Vaccinations work very well, but do not provide 100.00% protection. But, if you vaccinate everyone, then if someone does get sick, the disease can't spread because everyone is vaccinated, and there aren't enough susceptible people for the disease to get a toe hold into the population and cause an epidemic. This kind of immunity is called "herd immunity" and due to FUD spreaders like you and Wakefield causing lowered vaccination rates, we are loosing "herd immunity."

The fact that you would call public vaccinations, one of the the most important public health advances since the invention of proper sewer sanitation, a "leftist" plot shows the kind of ideological backwater that is arrayed against the science of public health.


Wakefield only gets attention because the public health authorities are not doing their jobs properly.


More FUD by you. They are doing their Jobs. And frauds like Wakefield, and FUD spreaders like you, are undoing their hard work. Lies spread faster than truth.
2.8.2009 2:31pm
Laura S.:
Professor:

The public and the research community have different perceptions of what "peer review" means. Its become commonplace to use the general-media to slam researched published outside of normal channels as not having been subject to peer-review. These arguments resonate with people because they are allowed to mentally attach a weightier meaning of "peer-review" than is factually accurate.

Conversely, anyone in academia knows that "peer-review" prior to publication is not intensive and tends toward censorship of rogue ideas rather than careful checking.

To wit: as a reviewer I am virtually alone in checking the content of the citations and doing independent literature searches. Once very dramatically, I'd found that the authors had previously published a very similar paper with rather different results--making no mention of the prior publication or the reason for the difference. I flagged this and submitted a weak reject. None of my co-reviewers detected the same mistake and had all voted accept!
2.8.2009 2:33pm
Roger Schlafly (www):
This kind of immunity is called "herd immunity" and due to FUD spreaders like you and Wakefield causing lowered vaccination rates, we are loosing "herd immunity."
I don't know about the UK, but there has been no loss of herd immunity for measles in the USA.
2.8.2009 2:48pm
Scote (mail):

I don't know about the UK, but there has been no loss of herd immunity for measles in the USA.



BBC:
Rise in measles 'very worrying'

MMR vaccine
Parents are urged to ensure their children get the MMR jab

Measles cases in England and Wales rose by 36% in 2008, figures show.


Chart

Your FUD has consequences. People are sick. Vaccinations are one of the greatest public health advances ever. Your attempt to demonize public health science as being "left" vs. "right" is reprehensible, IMO.
2.8.2009 2:57pm
Pauldom:
"I don't know about the UK, but there has been no loss of herd immunity for measles in the USA."

Are you ignorant on purpose? From the CDC website:

"The number of measles cases reported during January 1--July 31, 2008, is the highest year-to-date since 1996. . . . Measles is one of the first diseases to reappear when vaccination coverage rates fall."

The US is definitely trending downwards. How widespread will the epidemic need to be to convince you that vaccines might perhaps be a good idea?

Those at increased risk include babies and immuno-suppressed people who cannot get the vax. And kids have no ability to protect themselves once their parents wrongly decide vaccination is a leftist plot.
2.8.2009 3:39pm
pmorem (mail):
I think the peer-review process is fundamentally unsound and overrated. It does not meet current standards for being a "Quality Process".

Here's the equivalent process in my own work:

I work in Aviation as an engineer. My role is equivalent to "author" in this context. The role of "reviewer" is played by Inspectors and DERs. Their signatures carry weight and consequences. Inspectors and DERs can face serious penalties (including loss of license and even jail time) for poor verification.

Now, what consequences do "peer reviewers" face? Does anyone even know who the reviewers were in the Wakefield case? I searched for that information, but couldn't find it.

To meet the current standards, peer reviewers should affix their own signatures as having reviewed the paper. They need to be willing to take a stand and say, "Yes, I reviewed this, and it is good", otherwise the review just a rubber stamp.
2.8.2009 3:53pm
Elliot123 (mail):
"Like some climate deniers, Wakefield was in cahoots with a monied partner with a vested interest in the outcome."

Does a scientist who gets funding from organizations that fund research in favor of anthropogenic climate change have a monied partner? Would a scientist applying for a job with Hansen at NASA have a monied partner?
2.8.2009 3:57pm
Ak:
"To meet the current standards, peer reviewers should affix their own signatures as having reviewed the paper. They need to be willing to take a stand and say, "Yes, I reviewed this, and it is good", otherwise the review just a rubber stamp."

You realize that peer reviewers are volunteer experts in a given field who receive nothing for the considerable time they spend reviewing an article, right? Completely aside from the fact that this is not the sort of error peer review was meant to catch, declaring that they ought to face "consequences" would just decimate the number of people volunteering to review.
2.8.2009 4:10pm
neurodoc:
Scote and others responding to Roger Schafly, you are to be commended for your efforts to rebut the mindless crapola ("leftist plot"?!) he keeps serving up. You do realize, though, don't you, that you will never convince Roger and his scientifically illiterate and non-comprehending ilk, so what you are doing must be for the benefit of enlightening those who are not as determinedly benighted as he, and thereby benefitting all of us who are in this public health thing together, with our children most affected.

[Scote, was does "FUD" stand for? I expect it is very much on point here, so please tell me.]

Laura S, you say, "Conversely, anyone in academia knows that "peer-review" prior to publication is not intensive and tends toward censorship of rogue ideas rather than careful checking." Peer-review is, of course, almost always pre-publication, unless you want to count as peer-review that relatively rare occasions in which colleagues look into allegations of scientific fraud. (At one time, I worked in the Dept of HHS office charged with responsibility for investing such allegations, including some of the major ones of our time, e.g., Gallo and HIV controversy, and I can tell you those are very serious matters and treated as such.) I don't know what you have in mind with "tends toward censorship of rogue ideas." Are you asserting that good science has a hard time getting published if it doesn't conform to "conventional" thinking? I have been around some of the editors of the most respected medical journals and it is hard for me to imagine that "censorship of rogue ideas" is common on their watches. Any examples to offer?

Eugene Volokh, I think you have a bit crimped notion of peer review of medical publications in the best journals. To be sure, most of the time reviewers rely wholly on what has been submitted by the authors and those authors representations that they have complied with all the "rules." But if the editor or his/her reviewers have any doubts about the manuscript they are being asked to publish, they may ask specific questions of the authors or even request more than is contained in the manuscript itself, including the collection of more data. (A friend of mine thought too few animals had been studied to support the author's conclusion, so called for more work to be done. The author responded with it and his work was publised. Alas, it turned out that the author was a great fraudster, and it was no big deal for him to manufacture more phony data than he had offered the first time around.)

Often times, clinical research is conducted with IRBs (institutional review boards) and other oversight committees, which might be considered another form of "peer review." Not an absolute safeguard against scientific fraud, to be sure, but a help.

Also, there is the question of who are the "peers." I am familiar with one charlatan who advertises for patients in airline magazines. He claims that a great many neurologic disorders from Alzheimer's to multiple sclerosis are caused by the same pathophysiologic mechanism, that being "vasospasm," and of course he has a treatment to offer, that being vasodilators, for which he claims great success. They don't come much more phony than this. But he publishes and it is "peer reviewed." Except his work doesn't appear in any half-way credible journal, rather it is published online after review by the charlatan's peers, that is other charlatans?!
2.8.2009 4:16pm
neurodoc:
That Wakefield is incredible, maybe an outright fraudster, is by no means new news. But it may be seen how the consequences of such misconduct in medical research can live on long after the misconduct is discovered.
2.8.2009 4:20pm
CDU (mail) (www):

Scote, was does "FUD" stand for? I expect it is very much on point here, so please tell me.


Fear, uncertainty and doubt
2.8.2009 4:24pm
Guesty McGuesterson:
People, open your eyes. Science is a leftist plot to deny the unerring truth of the humors. Vaccines mess up your yellow bile and without leeches, we're all doomed. NOBAMA.
2.8.2009 4:26pm
Eugene Volokh (www):
Folks: Whatever your views on the subject, and however strongly they may be held, please be polite to each other. Insults aren't going to persuade either the target or other readers.
2.8.2009 4:27pm
neurodoc:
pmorem, it is the journal and its editors who put their good names on the line and suffer if it is subsequently discovered that published bogus results. Believe me, they are very jealous of those good names.

And as for the Lancet, well its not very high up in the pecking order of medical journals because it is less rigorous with regard to what it publishes. If an author could get published in the New England Journal or JAMA, for example, they would rather than do so in Lancet.

[Law journals and medical/scientific journals are very different animals. It is routine to offer an article to several law journals at the same time and go with the most prestigious that will have it; that isn't permitted with submissions to medical/scientific journals.]
2.8.2009 4:27pm
ChrisTS (mail):
If Wakefield is wrong, then he can be proved wrong with scientific data and evidence. It does not matter what his motives were.

His study has not caused any harm. Measles has been eliminated from the USA, and it remains eliminated except for any occasional case that comes in from overseas. If his paper cases people look more seriously at vaccine safety, so much the better.

The removal of thimerosal from vaccines was based on govt-declared limits on mercury intakes, and not on Wakefield. Are you suggesting that the mercury be put back in the vaccines?


I take the first comment has been fully dealt with by others. The second certainly has been addressed, but I feel the need to point out - along with others - that measles in the U.S. is on the rise. This is 'harmful' not only to those children whose parents chose to not have them vaccinated and to those children who catch measles from the former group. Recently, in CA., several children became very ill with measles which they contracted from an unvaccinated child in their daycare center. I bleieve none of the children died, but several were dangerously ill - and the long-term effects on their brain activity is yet to be determined.

The third point is so painfully illogical that I thnk I might as well go back to grading the papers of my 1st year philosophy students. I assume that they, at least, are educable.

P.S. Dare I ask what 'FUD' stands for?
2.8.2009 4:28pm
ChrisTS (mail):
Sorry: but also to those children who catch measles
2.8.2009 4:30pm
Eli Rabett (www):
In general, peer reviewers do not check citations, but they should be familiar with the field, and its literature, thus if something rings false, they should go check. This is one good reason to refuse reviewing anything you are not up to date on.
2.8.2009 4:33pm
ChrisTS (mail):
Sorry again: I see the link that explains FUD. You can imagine the possibilities I was considering.
2.8.2009 4:34pm
pmorem (mail):
Ak, neurodoc:

I appreciate your comments. I've thought about it, and my tone probably came across wrong.

My understanding is that within "quality process", the act of affixing a signature is actually sufficient consequence for most reviewers. The standard is "I have reviewed this, and it is of sufficient quality that I will affix my name to it". That is a very different standard from "I am willing to vote anonymously to approve this".

The standards the journals use appears to be "Someone we trust reviewed this, and it is sufficient quality that we will affix our signature". That's not the same standard, either. For it to work, it has to be the same person.

To say "Lancet is not a credible source" as an automatic refutation of any citations is useful, but not really sufficient. I'd like to see the journals that actually do care about their reputations seek out a higher standard.

In the mean time, I stand behind my statement:
I think the peer-review process is fundamentally unsound and overrated. It does not meet current standards for being a "Quality Process".
2.8.2009 4:57pm
Scote (mail):

neurodoc:
Scote and others responding to Roger Schafly, you are to be commended for your efforts to rebut the mindless crapola ("leftist plot"?!) he keeps serving up. You do realize, though, don't you, that you will never convince Roger and his scientifically illiterate and non-comprehending ilk,


Yes, you are right and I do realized that. I think it is important not to let Roger Schafly's ideologically motivated attacks on empirical science to go unchecked. Large epidemiological studies have proved that there is NO link between MMR vaccinations and autism. None. Not even a correlation. What Schafly is trying to do is to pretend to be interested in science, but when you look at his actual claims you can see that he is just trying to muddy the waters with false claims of scientific uncertainty. But there is no uncertainty on this issue. There is no link. The science is in, an it is definiative. And there never was a link. It was a fraud.
2.8.2009 5:06pm
Scote (mail):
BTW, I should note that attempts to feign an interest in science in order to falsely attribute doubt where there actually is none by real scientists is a page right out of the creationist playbook. It comes as no surprise that Roger Schafly, the one attempting to falsely cast uncertainty, has dedicated his website to fighting "Leftist Evolutionists."
2.8.2009 5:21pm
Eli Rabett (www):
Anyone interested in this should read Orac, a surgeon who has been perhaps the most active blogger in exposing Wakefield. His post on today's revelation can be found here
2.8.2009 6:09pm
Kevin P. (mail):

Eugene Volokh (www):
Folks: Whatever your views on the subject, and however strongly they may be held, please be polite to each other. Insults aren't going to persuade either the target or other readers.


I strongly agree and I vote that this also applies to:

Scote:
Like some climate deniers...
2.8.2009 6:26pm
Dr. T (mail) (www):
The antagonism towards Wakefield is a little strange.

Not to a physician. Lancet consistently had ranked in the top 10 English-language medical journals. Any article in Lancet, including a case control study, is supposed to have merit. Deliberate falsification of data that says vaccines are dangerous gives ammunition to the rabid anti-vaccination groups and worsens the problems faced by pediatricians and family practitioners. Resistance to immunization (puns are hard to avoid on this topic) is high in England and in the United States, and risk of autism is one of the commonest excuses for avoiding vaccines.
2.8.2009 7:01pm
Bob Goodman (mail) (www):
Peer review has a lack of accountability by design. The referees are anonymous specifically to isolate them from account. They make all sorts of editorial judgments which may or may not be helpful, such as whether findings are important or interesting enough to warrant publication.
2.8.2009 7:06pm
SenatorX (mail):
My son with Autism has a gut problem. It is one of the last components of his condition we have not been able to resolve yet through biomedical intervention. Regardless if you believe vaccines cause autism, believe that there is something wrong in the guts of many autistics. It will be nice when some helpful scientist explains what is causing this.

I also look forward to the vaccine debate being settled by tests of vaccinated vs unvaccinated groups. Too bad these tests keep getting shut down. The typical explanation lately is the money gets diverted to other more helpful studies such as proving autism has a genetic cause. That is a worthwhile direction though as we have many examples of global disease explosions caused by genetics.
2.8.2009 7:20pm
Tony Tutins (mail):

If an author could get published in the New England Journal or JAMA, for example, they would rather than do so in Lancet.

Not that publication in these journals shows that the arguments used and conclusions drawn are valid, as Kellerman's many articles on his epidemiological studies of gun control show (alluded to above).

The problem with scientific studies: Some few researchers fake their data. The only way to detect this is to reproduce their experiments. Peer reviewers are not about to spend the time and resources to do so, to eliminate the slight possibility that the paper is fraudulent. Thus, any plausible study will get published.

The most likely person to detect fraud in a typical academic research setting is the grad student who take up the project when his predecessor graduates, who finds that he can reproduce none of the previous results.
2.8.2009 8:10pm
Scote (mail):

I also look forward to the vaccine debate being settled by tests of vaccinated vs unvaccinated groups.


Such studies have already been done. I'm not sure why you think they have not. All you have to do is click on the links in guest890's post to see but a few of these studies.

The vaccine debate is settled. The science is in. There is NO, zero, zilch, nada, link between autism and MMR vaccines, none. And the "study" that claimed there was is a **fraud**.

You aren't going to find evidence if you are unwilling to see it when it is right in front of you.
2.8.2009 8:15pm
neurodoc:
SenatorX: I also look forward to the vaccine debate being settled by tests of vaccinated vs unvaccinated groups. Too bad these tests keep getting shut down.
First, I don't know what "vaccine debate" you think is unsettled. Whether you accept that childhood vaccines are not the cause of autism is not clear, but the scientific world is not in serious doubt about the matter, having concluded that there never was anything convincing evidence for it and more evidence has disposed of any case there may have been for that speculation. (If you want to say that assertion is not 100% true in light of the Poling case, I will say that the Poling case doesn't stand for more than that a non-specific stressor can cause a child with a mitochondrial disorder injury, but be less categoric and maintain vaccines bear no relationship to 99.9% of autism cases.)

Then, I don't know what you have in mind when you allude to "tests (that) keep getting shut down." Can you provide us of the specifics? Most clinical trials are major undertakings and do not get shut down except in the most unusual of circumstances, including getting a definitive answer much sooner than expected.

As for why "tests of vaccinated vs unvaccinated groups" are not being done, money is only part of the answer, and not the most important part. When one has an proven effective measure to treat or prevent a serious medical condition, like penicillin for pneumonia or MMR to protect against measles, mumps, and rubella, it is unethical to withhold that measure in order to do a trial. So there will be, and should be, no clinical trials with children randomized to a trial arm of those who will be given a proven vaccine and to another trial arm in which the vaccine will be withheld. What may be done is look for opportunities presented by "experiments of nature," when for some reason a population of children goes without vaccine for reasons beyond the control of investigators and their experience is compared to that of children who have been vaccinated.
2.8.2009 8:18pm
neurodoc:
Tony Tutins: The problem with scientific studies: Some few researchers fake their data. The only way to detect this is to reproduce their experiments.
That is not the only way that fraudsters get discovered. Sometimes their work just gets more scrutiny than it did originally and it all starts coming apart. See, for example, the story of Cyril Burt. John Darcy managed to publish quite a bit of bogus medical research in good journals until he was ratted out by a colleague, and when another look was taken at those papers, some things jumped right off the page, e.g., a family pedigree which implied that an individual had been only 10 years old when he fathered one of those in the kindred. (Yes, there are some places where they start breeding when they are very young, but 10 years old is rather farfetched even in those places.)
2.8.2009 8:41pm
http://volokh.com/?exclude=davidb:
Neurodoc:

As someone with a real stake in the autism wars, I'm very grateful for your well-reasoned arguments in favor of evidence-based medicine and the rational use of research dollars.

My gratitude also goes out to the rest of you who rail against FUD (and you know who you are). It's tremendously heartening to read your words.

Roger Schafly, I find that I am grateful to you too, in a way, for the unspeakably inane arguments you bring to this table -- arguments that, on their face, further discredit you and your ilk. Oh, and good luck with that Creationism thing, too.
2.8.2009 8:43pm
Kirk:
Laura,
Once very dramatically, I'd found that the authors had previously published a very similar paper with rather different results--making no mention of the prior publication or the reason for the difference. I flagged this and submitted a weak reject. None of my co-reviewers detected the same mistake and had all voted accept!
If you would be able to say a bit more about this, "weak reject" seems like a very cautious response to a huge red flag--could you amplify on this response a bit?
2.8.2009 8:45pm
John Moore (www):

Not to a physician. Lancet consistently had ranked in the top 10 English-language medical journals. Any article in Lancet, including a case control study, is supposed to have merit.

Unfortunately, Lancet's brand is being tarnished. The solid refutation of the Iraq civilian deaths article is another example.

I suspect there may be more dishonest scientists than in the past - perhaps because the field has grown so much, and because of professional pressures and idological fanaticism. Science is vulnerable to fraud and misrepresentation, especially if the fraud supports a consensus.

The climate change debate shows another weakness of modern institutionalized science: those who support the "consensus" are not always required to support their data (cf Hansen for quite a while).

None of this is meant to condemn science, but rather to remove it from a position of infallibility - something no sane scientist claims anyway. It is still the most powerful method we know, by far, to determine truth about the natural world.
2.8.2009 8:51pm
Roger Schlafly (www):
[Scote] I think it is important not to let Roger Schafly's ideologically motivated attacks on empirical science to go unchecked. ... a page right out of the creationist playbook. ...
I have not attacked empirical science, and I am not a creationist. I do not claim that MMR or thimerosal causes autism, and I think that it is extremely unlikely. I am very much in favor of scientific studies that compare the benefits, risks, and costs of popular vaccines. I rely in such info myself when I decide what vaccines to get. I am the one who is supporting science here.

I do wonder why anyone cares about Wakefield's motivations, or about mine. If you want to prove that MMR vaccines are wonderful, then just cite the scientific evidence. You are not going to establish any scientific position by making ad hominem attacks.
2.8.2009 9:37pm
Tony Tutins (mail):

Lancet's brand is being tarnished. The solid refutation of the Iraq civilian deaths

Citation to solid refutation?
2.8.2009 9:46pm
Scote (mail):
Leftist Evolutionists
I have not attacked empirical science, and I am not a creationist. I do not claim that MMR or thimerosal causes autism, and I think that it is extremely unlikely...

And yet, in spite of the many epidemiological studies that have shown that there is NO correlation, you still won't say that MMR vaccines don't cause autism. Funny that.

Note that I did not call you a creationist, though it certainly seems likely given your self-processed mission against "Leftist Evolutionists." What, pray tell, is the antithesis of "Leftist Evolution?" Perhaps you are one of those lab coated creationists who call themselves advocates of "intelligent design theory" (*cough*creationists*cough*).

You are not going to establish any scientific position by making ad hominem attacks.

Noting that you are a politically motivated ideologue is hardly an Ad Hominem and it is certainly relevant to understanding your poorly supported position.
Actually, noting that you ar
2.8.2009 10:06pm
Scote (mail):
errata:

The first paragraph of my preceding post is by Roger Schlafly and was meant to be a Block Quote.
2.8.2009 10:10pm
AnonLawStudent:

If you want to prove that MMR vaccines are wonderful, then just cite the scientific evidence.

See the Cochrane Collaboration report here (PDF).


I do wonder why anyone cares about Wakefield's motivations, or about mine.

Because scare-studies attract media attention, not to mention lawsuits. Absent a mulit-hundred dollar subscription, published articles run about $30 each. Very few parents have the resources or the knowledge to analyze the available science.
2.8.2009 10:17pm
SenatorX (mail):
Scote I read those links but they don't say what you suggest. What is your stake in this anyway to have such vitrol? Do you know yet what causes autism or what the cure is?

Infant Primates Given Vaccines On U.S. Children's Immunization Schedule Develop Biomedical And Behavioral Symptoms Of Autism

Using infant macaque monkeys, University of Pittsburgh's Dr. Laura Hewitson, Ph.D., described how vaccinated animals, when compared to unvaccinated animals, showed significant neurodevelopmental deficits and "significant associations between specific aberrant social and non-social behaviors, isotope binding, and vaccine exposure."

Researchers also reported, "vaccinated animals exhibited progressively severe chronic active inflammation whereas unexposed animals did not" and found "many significant differences in the GI tissue gene expression profiles between vaccinated and unvaccinated animals." Gastrointestinal issues are a common symptom of children with regressive autism.


How about you stop speaking for "the scientific world" neurodoc? You started the "vaccines are the safest most tested science ever" argument here years ago and yet I keep showing you new studies all the time that show how poor the science has been. What gives?
2.8.2009 10:31pm
John Moore (www):
Citation to solid refutation?


Which one. Use Google. The study methodology was junk.
2.8.2009 10:44pm
Liz Ditz (mail) (www):
I've done another round-up post -- who is saying what about the Deer articles on Wakefield in the London Times. I've included this post.

11 years on, Wakefield Manufactured Data showing MMR-Autism Link?
2.8.2009 10:46pm
Roger Schlafly (www):
Scote says that I am "trying to muddy the waters with false claims", and yet he cannot point to any false claim. He says that I am part of a "ideological backwater", and that my comments are "right out of the creationist playbook." And yet he denies calling me a creationist or making an ad hominem attack.

No matter. If the latest MMR/autism studies convince you to get the vaccine for yourself or your kids, go ahead. I am not doubting those studies. I favor letting people decide for themselves.
published articles run about $30 each
The CDC makes its articles available for free on its web site.
2.8.2009 10:58pm
Tony Tutins (mail):

The study methodology was junk.

Ah. Proof by repeated assertion.

I was afraid of that.
2.8.2009 11:01pm
Sagar:
Tony Tutins:

did you miss the advice to "google it"?
2.8.2009 11:11pm
Milhouse (www):
I'm surprised nobody's yet picked up on this:

His study has not caused any harm. Measles has been eliminated from the USA, and it remains eliminated except for any occasional case that comes in from overseas.

Ah, I see. The study has not caused any cased of measles in the USA; therefore it has not harmed anybody.
2.8.2009 11:14pm
theobromophile (www):
I suspect there may be more dishonest scientists than in the past - perhaps because the field has grown so much, and because of professional pressures and idological fanaticism. Science is vulnerable to fraud and misrepresentation, especially if the fraud supports a consensus.

Isn't the real issue that science is used to support so many policy positions that people have a strong incentive to back themselves up with whatever is available (whether or not it really supports their position, if analysed without bias)?

I guess this is where my libertarian instincts kick into high gear. If a small, limited government is not going to change its policies, no matter what the science says, then there's less of a payoff for manipulating science (tests, results, reporting thereof) to support one's ideological positions. In theory, then, there would be less manipulation going on.
2.8.2009 11:15pm
guest890:
SenatorX:
I keep showing you new studies all the time that show how poor the science has been.

Speaking of bad science, the study you cite has been criticized for its methodology.
(Many, many questionable methods; read the article.)

In addition, the researcher's objectivity is severely in question.
(Short version: Affiliation with Wakefield's organization, affiliation with anti-vaccination DAN! organization, currently a plaintiff in a vaccination-related lawsuit against HHS regarding her autistic child (a lawsuit which she conveniently forgot to mention as a conflict of interest when submitting her research)).
2.8.2009 11:22pm
Tony Tutins (mail):

did you miss the advice to "google it"?


What I learned from "googling it": Researchers said that the controversial estimate is "likely accurate," and another group determined that the death toll between March 2003 and August 2007 fell in the range between 946,000 and 1,120,000.

21 Oct 2006 21:25:20 GMT
Source: Reuters
Printable view | Email this article | RSS [-] Text [+]

Background
Iraq in turmoil
More By Deena Beasley

LOS ANGELES, Oct 21 (Reuters) - A controversial estimate by public health experts that hundreds of thousands of Iraqis have died because of the March 2003 U.S.-led invasion of Iraq is likely an accurate assessment, researchers said on Saturday.

"Over the last 25 years, this sort of methodology has been used more and more often, especially by relief agencies in times of emergency," said Dr. David Rush, a professor and epidemiologist at Tufts University in Boston.

The study, published earlier this month by the Lancet medical journal, employed a method known as "cluster sampling" in which data are collected through interviews with randomly selected households.

Critics, including President George W. Bush, have said the results are not credible, but Rush said traditional methods for determining death rates, such as counting bodies, are highly inaccurate for civilian populations in times of war.

Researchers from Johns Hopkins University in Baltimore and Al Mustansiriya University in Baghdad estimated with 95 percent certainty that the war and its aftermath have resulted in the deaths of between 426,000 and 794,000 Iraqis.

Other estimates have calculated the number of extra Iraqi deaths to be much lower. The Iraq Body Count Database calculates that between 43,850 and 48,693 extra civilians have died since the invasion.

Rush, speaking at a meeting in Los Angeles on the medical consequences of the Iraq war, said that the relatively small size of the sample -- 1,849 households -- doesn't change the findings, although it does widen the "confidence limits," hence the large range of the estimated additional deaths.

In addition, the biases inherent in cluster sampling, such as wording of questionnaires, would tend to undercount, rather than inflate, the number of deaths, Rush said.

"I think this is an extremely credible study," said Michael Intriligator, professor of economics at the University of California at Los Angeles.

Intriligator, who said he commonly uses cluster sampling in his own work, noted that the study's most remarkable finding was the death rates in the country have risen from 5.5 per thousand Iraqis per year before the invasion to 13.2 per thousand per year as of the study's July cutoff.

In addition to violence, death rates in Iraq are on the rise because of threats to public health, including poorly equipped hospitals, said activist Dr. Dahlia Wasfi.

"The affects on the civilian population of the war in Iraq have been grossly underestimated," said Jonathan Parfrey, executive director of the Los Angeles chapter of Physicians for Social Responsibility.

January 2008 - Update on Iraqi Casualty Data
Further survey work undertaken by ORB [UK polling firm Opinion Research Business], in association with its research partner IIACSS, confirms our earlier estimate that over 1,000,000 Iraqi citizens have died as a result of the conflict which started in 2003.

Following responses to ORB's earlier work, which was based on survey work undertaken in primarily urban locations, we have conducted almost 600 additional interviews in rural communities. By and large the results are in line with the 'urban results' and we now estimate that the death toll between March 2003 and August 2007 is likely to have been of the order of 1,033,000. If one takes into account the margin of error associated with survey data of this nature then the estimated range is between 946,000 and 1,120,000.
2.8.2009 11:59pm
Ricardo (mail):
Do you know yet what causes autism or what the cure is?

This is a common tactic among "skeptics" of various colors. Science doesn't work by providing complete explanations for everything under the sun. It works by progressively falsifying some hypotheses and weakly confirming others until we begin to narrow in on the truth. In other words, we don't need to know exactly what causes autism in order to rule out certain causes.

According to the link someone posted in response to the monkey study, the total sample size was 15 with 3 in the control group and 12 in the treatment group. Jeez, if you're going to quote "scientific" studies at least give us something with a sample size of at least 100 that is evenly divided between control and treatment.
2.9.2009 12:14am
allison (mail):
Prof. Volokh,

While your comment update about peer review is correct that peer review can't uncover fraud per se, that alone doesn't get the Lancet or peer review off the hook.

Peer review is supposed to provide critical judgment of the submitted paper and results--not just find errors in clarity. The reviewers are supposed to know their field well enough to judge whether a result is plausible, interesting, and noteworthy. Especially noteworthy results are supposed to be held to higher standards of skepticism.

The journal and its reviewers failed on these accounts. They did not find a study of a tiny set of children with an ENORMOUS correlation in that set eye raising enough to behave skeptically. They didn't question the statistical likelihood of it happening. They didn't wait to see repeatability in a larger set before acceptance for publication.

The paper was making a very strong claim, and they went forward with it unduly. The reviewers did not behave with enough curiosity given the dramatic claim being put forth, which is the whole point of peer review.
2.9.2009 12:25am
John Moore (www):
Measles. - An very recent example showing the impact of inadequate vaccination. These appear pretty frequently.

From Pro-Med (an epidemiology alerting mailing list) Emphasis added:
<blockquote>

Date: Fri 6 Feb 2009

Measles outbreak in Switzerland: update
———————————————————-
Swiss federal health authorities late Thursday [5 Feb 2009] issued an alert about the measles outbreak in Vaud this week, reminding people that the virus causes serious illness and <b>vaccinations are the only protection against the potentially deadly disease.</b>


Since the start of 2009, 50 new cases have been declared in
Switzerland, half of them this week alone, in Vaud [canton] — the number of cases seen in a total year when there is not an epidemic. Four new schools were affected Thursday [5 Feb 2009] when brothers and sisters of the 17 students with measles from the Rudolf Steiner school in Crissier also fell ill. Children and teenagers who have not been vaccinated and who have had contact with anyone with measles must by law be sent home for 3 weeks.

Bern noted that since November 2006 Switzerland has seen 3400 cases of measles, <b>with one death last week</b> [week of 26 Jan 2009] in Geneva, <b>250 hospitalizations</b> and 500 complications that included 143 cases of pneumonia and <b>8 cases of encephalitis</b>. <b>Six people have died </b>in Europe from measles in recent years. There is no [specific] treatment for the disease.

<b>93 percent of those treated for measles in Switzerland were not fully vaccinated.</b> The government recommends 2 vaccinations, at 12 months with a follow up at 15-24 months. One concern is young people who received the initial vaccination but not the follow up. Health authorities recommend vaccinations for anyone born after 1963 who is not vaccinated and who has not had measles.

Bern notes that <b>measles has been eradicated in North and South America</b> as well as in Finland [the Americas have interrupted endemic transmission of measles virus, but there are period small outbreaks related to imported cases.

...

Switzerland is the hardest hit country in Europe, with its 3-year-old epidemic and <b>the only way to eradicate the disease is to achieve a 95 percent vaccination coverage</b> for young children. Nationwide, the coverage is currently 86 percent.
</blockquote>



2.9.2009 1:00am
SenatorX (mail):
No Ricardo it's not a tactic. I have a sick son and need him cured. You offer no other theory to refute and the vaunted studies disproving the links between vaccines and autism have all been debunked as well. If we had time we could go through them all and you would see the glaring holes of methodology and logic, I am sure of it. I ask for more science, more questions, more tests until a cure is found. I have science degrees and I read Popper so I know what you are saying. What I don't like is those that say refutations are complete and no more studies looking at vaccines need to be done. That vaccines are completely safe. This is what smacks to me of blindness and ideology (also obedience to authority which is ironic on a libertarian site). Science should be always questioning, there is never an and to it. How are people going to tell me over and over vaccines are safe when some babies and children can and do die when vaccinated. It is an undisputable fact. The question at hand is: is there a larger subset of the human population that doesn't die but gets sick when exposed to certain vaccinations, the increased amount of vaccinations these days, or when having a pre-existing condition that makes them susceptible to harm from vaccination.

You are right a larger study needs to be done and I hope you support that. There also need to be studies on the affects of multiple vaccinations at once. Also studies on the kids that are recovered which for some reason nobody is interested in. If you want we can continue to do studies on older fathers, refrigerator mothers, parents who work in IT, and genetics but the question of a vaccine link should not be taboo.
2.9.2009 1:03am
ChrisTS (mail):
1) Science is an endeavor, an enterprise, a set of methods for pursuing truth (within specified parameters). That some scientists at a given moment in history do not live up to the standards of the endeavor is hardly a criticism of the enterprise. This is a basic logical distinction. I imagine few of us would accept an argument of the form, "Some X-ers have done/said this; therefore, the field/party/religon X is all a charade."
That science, in particular, is a powerful, successful enterprise and essential to most of what we like to call 'modern medecine,' 'technology,' and first-world 'knowledge' makes it an especially inapt target of a combination ad hominem and part-whole fallacies.

2)As for why "tests of vaccinated vs unvaccinated groups" are not being done, ....

Thank you, Neurodoc for answering this outrageous 'challenge.' Who - with any sense of ethics whatsoever - would think that studies subjecting some infants to non-vaccination could be ethical?

I have to say, that given all the conversation on VC about the problems on Balkanization and other blogs, I'm surprised by the number of 'trolls,' here.
2.9.2009 1:09am
Erick:

Technically true, but misleading.

Thiomersal (INN) (C9H9HgNaO2S), or sodium ethylmercurithiosalicylate, commonly known in the United States as thimerosal, is an organomercury compound (approximately 49% mercury by weight) used as an antiseptic and antifungal agent.

I see no reason to be coy about such a fundamental fact: Thiomersal / Thimerosal is a compound of Hg. That has no bearing on whether Hg or any of its compounds cause autism or any other condition.

It's not being coy. There are very significant differences between methylmercury (what people usually mean when they say "mercury") and ethylmercury (thimerosal). When people cry about how horrible it is that the government is putting mercury in our children, its important to know that is a significantly less dangerous substance than what the antivaxers want you to think it is.
2.9.2009 1:19am
Dan Simon (mail) (www):
I'm surprised that so many people around here are having trouble understanding Roger Schlafly's position. He's what I'd call an orthodox libertarian on health care, meaning that he believes that the government has no business interfering with individuals' personal health care decisions. That would make him opposed to pretty much everything normally considered "public health"--including, for instance, all government efforts to increase the rate of vaccination.

He likely also agrees with some libertarians I've argued with who believe that the FDA is to blame for thousands of deaths because it requires very high standards of scientific proof before allowing marketers of medical treatments to claim safety and effectiveness. They argue that many people would happily try various as-yet-unproven experimental drugs--including many that are later proven safe and effective--but cannot obtain them because of FDA rules.

Of course, a much larger number of people would die under more relaxed rules, because they would fail to see through snake oil salesmen's careful circumventions of fraud laws, get fooled into thinking that the snake oil is safe and effective, and miss out on proven-effective treatments as a result. To libertarians, these deaths are apparently of much less concern, because they are deemed to have been caused by the patients' own ignorance or incompetence, rather than by the medical scam artists who fooled them into taking expensive, useless nostrums.

Similarly, if the government stopped pushing people to get vaccinated, a great many people might end up getting persuaded by charlatans like Wakefield, forgo vaccination, and die. But their deaths would be a result of their own gullibility, and therefore much less disturbing than, say, the far fewer deaths caused by an increase in vaccine side effects resulting from government "coercion" used to increase vaccination levels.

Personally, I consider this point of view nutty, but I'm surprised that so many Volokh Conspiracy readers fail to see its basic congeniality with libertarian principles.
2.9.2009 1:40am
Ricardo (mail):
Similarly, if the government stopped pushing people to get vaccinated, a great many people might end up getting persuaded by charlatans like Wakefield, forgo vaccination, and die. But their deaths would be a result of their own gullibility, and therefore much less disturbing than, say, the far fewer deaths caused by an increase in vaccine side effects resulting from government "coercion" used to increase vaccination levels.

But it's not a "personal" health decision. Decisions to smoke, drink, use herbal remedies or whatever else are personal since the health damage affects only the person making the decision. Not getting vaccinated means that not only are at an increased risk of infection but also that you have a higher chance of harboring the virus and spreading it to others.

This has already been covered here and elsewhere but no vaccine is 100% effective. Those of us who have been vaccinated are therefore at a higher risk of contracting serious illnesses because of some who choose to not get vaccinated.

One example is India where a couple of nutty Imams have spread the idea that polio vaccine is a plot to sterilize Muslims so some relatively uneducated Muslims do not get vaccinated. The result is that polio -- a disease that should have been wiped from the face of the earth by now -- jumps to the vaccinated population in India and some strains of polio originating in India have infected vaccinated people in other countries too.
2.9.2009 2:45am
Roger Schlafly (www):
a great many people might end up getting persuaded by charlatans like Wakefield, forgo vaccination, and die.
I don't have to be a radical libertarian to reject such alarmist nonsense. No one in the USA has died of measles in the last ten years since Wakefield published his infamous paper.

Wakefield is not a threat. If you don't like what he has to say, then ignore him or rebut him.
2.9.2009 4:13am
jukeboxgrad (mail):
tony:

What I learned from "googling it"


Yes, but the people who advised you to do that are assuming that you have the same special version of google that they use. I mean the one that only returns results from National Review, Weekly Standard, and Power Line.

You can't expect to get good results unless you use the right version of google.
2.9.2009 7:26am
Richard Aubrey (mail):
Lancet doesn't have to ramp up their peer-reviewing of their peer-reviewing. Unless they want credibility. Their choice.
The Iraqi death toll study started with a pre-invasion death rate of 5.5. Where does that stand in relation to other nation's death rate? Hint: Really, really, surprisingly low. Really low.
2.9.2009 8:09am
Tracy W (mail):
I'm starting to think that academic journals should be checking the source data as a matter of course, particularly in medicine. It would be expensive, but how much money has been spent trying to check Wakefield's original claims, and on dealing with the anti-vaccers, and on the medical and personal costs of the resurgence of measles in the UK and other countries?
2.9.2009 8:16am
jukeboxgrad (mail):
aubrey:

The Iraqi death toll study started with a pre-invasion death rate of 5.5. Where does that stand in relation to other nation's death rate? Hint: Really, really, surprisingly low. Really low.


Thanks for giving us yet more proof that you use the special version of google that returns only results that you like.

See if you can get your google fixed, and then you might be able to find this:

most Middle Eastern nations really do have lower death rates than most European countries, and in fact have lower death rates than 5.5. Jordan's death rate is 4.2, Iran's 5.3, and Syria's 3.5. The reason for the lower rate is simple: Most Middle Eastern nations have much younger populations compared to most Western nations.


Note that in Kaplan's reply, he does not address this issue.

Also here you can find an analysis showing multiple sources to substantiate the pre-invasion death rate of 5.5.
2.9.2009 8:29am
Joe in NM:
The idea of reproducible research comes to mind here, it might limit some controversy. I'd like to see public access to the raw data, a record of the decison-making used for data selection, a specific list of the software tools used to analyze and reduce the data, the source code for any custom software used to analyze the data and produce tables and graphs in the published results, etc.

Publish enough information for those skilled in the art to reproduce the results. This is more than peer-review of results. Much more.

Check out this excellent paper for a better discussion: Victoria Stodden, The Legal Framework for Reproducible Research in the Sciences: Licensing and Copyright, IEEE Computing in Science and Engineering, 11(1), p. 25-20, (Jan. 2009) link
2.9.2009 8:33am
r crimaldi (mail):
everyones missing the underlying cause of autism. we are living in such a toxic enviroment,that our bodies can not handle these vaccines,whether or not they mercury,are giving seperatly;etc. it is our bodies that are reacting to the vaccines.maybe we should spend more time studying that idea and maybe we can get some answers 1
2.9.2009 9:11am
Richard Aubrey (mail):
Geez, juke,
Here I was happily ignoring you and you got me back in. "Just when I think I'm out, they pull me back in!" You may be lacking a number of the more common virtues, but you can sure bust through the determination to ignore you.
Point is, juke, that Iraq didn't have that many kids. You recall the sanctions killing half a million a year. You can't do that and still have enough kids around to keep the death rate down.
I guess I should have made the entire point, which everybody else would get.
Anyway, you pick your poison: If the sanctions foes lied, then the death rate might be accurate. Or turn it around. Doesn't matter to me.
Now, I'm going to flog myself for my lapse. Hope it never happens again.
2.9.2009 9:58am
Milhouse (www):

I don't have to be a radical libertarian to reject such alarmist nonsense. No one in the USA has died of measles in the last ten years since Wakefield published his infamous paper. Wakefield is not a threat.

And here he is again, with exactly the same non-sequitur. No one in the USA, he claims, has died of measles since Wakefield published his paper. Therefore the paper is not a threat. Am I really the only one who sees the problem here?
2.9.2009 11:52am
Roger Schlafly (www):
I'm starting to think that academic journals should be checking the source data as a matter of course, particularly in medicine.
Forget it. Medical journals publish a lot of papers with results that turn out to be wrong for various reasons. They are just not able to be sure about the results.

I think that it would be better for the vaccine promoters to put out good studies, than to try to figure out new ways to censor those with contrary views.
2.9.2009 11:56am
Abdul Abulbul Amir (mail):

He likely also agrees with some libertarians I've argued with who believe that the FDA is to blame for thousands of deaths because it requires very high standards of scientific proof before allowing marketers of medical treatments to claim safety and effectiveness. They argue that many people would happily try various as-yet-unproven experimental drugs—including many that are later proven safe and effective—but cannot obtain them because of FDA rules.

Of course, a much larger number of people would die under more relaxed rules, because they would fail to see through snake oil salesmen's careful circumventions of fraud laws, get fooled into thinking that the snake oil is safe and effective, and miss out on proven-effective treatments as a result.


Maybe so and maybe not. No one I know thanks drugs should be allowed on the market that are not proved safe. OTOH, what is effective for one may not be effective for another.

Proving both safe and effective for one more headache pill, no problem. But requiring years of additional testing past safety testing on effectiveness for people who will die of disease for which no effective alternative medication exists for them is cruel and immoral.
2.9.2009 12:25pm
NowMDJD (mail):
To understand peer review, one must look at three conceivable functions. In doing so, one must understand that the key to a scientific publication is the data. The references are tertiary to the data (primary) and the conclusions (secondary). The references just document that the work is original, and rarely add anything else to the publication. I have long been a peer reviewer, and so speak from knowledge and experience. Here are the functions.

1. Whether the data presented are internally consistent, and whether they support the conclusions. A good peer reviewer will do this.

2. Whether the references are correct, and say what they are supposed to say. Accuracy in reporting references is important in a court opinion, a brief, or a law review article, where the citations ARE the data. Because of their relative lack of importance in medical literature , They do not receive the same attention by the reviewers. A good peer reviewer will investigate at least to the point of asking if there are any data in the references that seemingly conflict with the data presented in the instant publication. This is common, and does not indicate fraud. But the authors of the paper being reviewed must be asked to explain why the two studies produced differing data.

3. The accuracy of the data itself is NOT part of the peer review process. The reviewer does NOT have access to the raw data. In most cases the data is not audited by anyone. Certainly not by an IRB or the journal. Rarely, either may occasionally review lab notebooks or clinical records if there is reason to suspect fraud. Some studies are subject to audit by funders or the government. But this is NOT (as I sayd before, not ) part of the peer review process.

There are instances in material I have reviewed in which data were internally inconsistent. If a would-be fraud who knows the subject area well is careful, he can concoct data that will fool any peer reviewer.

I believe that Prof. Volokh wasn't clear of the difference between my #2 and #3. I hope this clarifies matters for him and other readers of this thread.
2.9.2009 12:32pm
Brian Mac:
Abdul Abulbul Amir:

The FDA doesn't require that drugs are "proven safe" before they reach the market. Tell your friends to take a look at the leaflets that come with their tablets - they may notice that mention is made of the occasional unwanted side effect . Also, drugs can't be proven safe in the first place. And finally, drugs are subject to trials to show that they actually have a clinical benefit (i.e. are effective) before they are allowed on the market.

Apart from that - I agree wholeheartedly!
2.9.2009 12:35pm
guest890:
SenatorX:
the vaunted studies disproving the links between vaccines and autism have all been debunked as well.

Roger Schlafly:
I think that it would be better for the vaccine promoters to put out good studies...


Citation, please.
There have been many studies that have failed to find a link; I linked to a few of them above (and there are more). Yet you both seem to be claiming that none of these studies are any good.

I'm sure you can find a few issues with some of the studies showing no link, because you can find issues with any medical study. But there are numerous studies, and I haven't heard of anything like blatantly falsifying data, so SenatorX's claim (and Roger's implication) that they "have all been debunked" is quite strong.

than to try to figure out new ways to censor those with contrary views.

Wakefield is not a threat. If you don't like what he has to say, then ignore him or rebut him.

Didn't this entire discussion get started by a rebuttal? Giving evidence that he falsified data in his study--not just allegations that he did, mind you, but specific and significant discrepancies--should render all of his conclusions worthless. Showing that someone has committed scientific fraud is not "censorship".

As for ignoring him, I would very much like to. Unfortunately, there are a number of people who have decided that he's right, and ignore any evidence to the contrary--and try to convince others of Wakefield's bogus claims. Ignoring him will result in the false information spreading further.
2.9.2009 12:44pm
Roger Schlafly (www):
Giving evidence that he falsified data in his study--not just allegations
No there are just allegations by a newspaper reporter that "In most of the 12 cases, the children's ailments as described in The Lancet were different from their hospital and GP records." The specifics are not even published anywhere, as far as I know.

A lot of people have been out to destroy Wakefield for the last ten years. I think that is a little strange. And now I am supposed to believe that with all the time, money, and energy spent trying to destroy Wakefield for the last ten years, no one even bothered to look at his data? And now, after ten years, a reporter looks at some records, talked to a couple of people, and declares Wakefield a fraud? I think that Wakefield's enemies should do some real science themselves.
2.9.2009 1:19pm
Brian Mac:

I think that Wakefield's enemies should do some real science themselves.

So if all those researchers since Wakefield who looked (in vain) for MMR-autism links haven't been doing "real science," what have they been doing?
2.9.2009 2:31pm
loki13 (mail):
After watching Schafly-bot's posts (warning, may contain susbstance-free words), I can finally understand why Prof. Barnett shut down his comments.

Pity.
2.9.2009 2:35pm
Dan Simon (mail) (www):
Proving both safe and effective for one more headache pill, no problem. But requiring years of additional testing past safety testing on effectiveness for people who will die of disease for which no effective alternative medication exists for them is cruel and immoral.

I think you're missing the point. The key property of the FDA's rigorous standards for proving treatments "effective" is that without FDA approval, marketers can't market their products as effective treatments. If the FDA were to relax its standards, a few effective treatments would be approved, and get marketed, sooner. But many, many more completely ineffective treatments would manage to pass the new relaxed standards, and get marketed as effective. The net result, in the long term, would be many, many more patients being diverted to ineffective treatments by disreputable snake oil salesmen.
2.9.2009 2:49pm
Dan Weber (www):
No one I know thanks drugs should be allowed on the market that are not proved safe.

No such thing. All drugs have side-effects. The question should be how the side effects compare to the imputed improvement.

I have a sick son and need him cured. ... What I don't like is those that say refutations are complete and no more studies looking at vaccines need to be done.

There are a finite number of research dollars. Why in the world would we waste them investigating vaccines? The original study that found correlation has turned out to be either incredible irresponsibility or outright fraud on Wakefield's part.

If the bar is so low that we study vaccines, why not pour money into seeing if cell phones, color TV, magnetic fields, or blacks being able to vote cause autism?
2.9.2009 5:30pm
Splunge:
As someone who has participated in plenty of peer review in scientific (although not medical nor epidemiological) journals, both as reviewer and reviewee, I think there is a fundamental flaw underlying the popular notion of what "peer review" means, and how science goes about validating (or invalidating) its claims.

Peer review does nothing to prevent bogus claims and discoveries from getting into print in the first place. It can't. Since a discovery is by definition the first observation of a phenomenon, a report of it cannot be vetted by someone knowledgeable in the field without duplicating the discovery experiment. To be sure, peer review can weed out "discoveries" that plainly contradict established physical law, e.g. "discoveries" of perpetual motion or instantaneous action at a distance. But science is deliberately cautious about doing so, because of course many fundamental advances were, at one time, apparent violations of established physical law. Quantum mechanics implies the violation, under certain circumstances, of the law of Conservation of Energy. Relativity plainly violates Conservation of Mass, and so on. We do not want to forbid the presentation of experimental results simply because they appear to be implausible or bizarre.

However, what has been forgotten is that no one in his right empirical scientific mind takes the initial discovery of a phenomenon at face value. No phenomenon, until it has been independently confirmed, is anything more than an interesting suggestion. No sound empirical thinker would take consequential action based on the first report linking MMR vaccines to autism, no matter where published, no matter by whom submitted, no matter how much or how little data was included in the article, no matter how persuasive or flimsy the accompanying logic, until it had been independently duplicated elsewhere.

And that's where peer review comes in. Peer review makes sure that phenomena that have not been independently duplicated get harder and harder to publish, because people knowledgeable in the field are aware of that fact. If someone submits a paper with a novel, wildly implausible claim about vaccines that is apparently backed up by his data, there's nothing wrong with allowing it to be published. Suppressing it because it violates orthodox thought is not a legitimate function of scientific peer review, however common it may be in less empirical fields.

However, if the first paper is discredited, or even not supported by the attempts of others to duplicate its results, then peer review very properly suppresses the second paper with the implausible -- and now independently discredited -- claim.

In short, peer review does not prevent error and fraud from getting into print at all -- it just ensures that the lifetime in print of the error is as short as possible.

For the informed laymen, the lesson here is that the appearance of a conclusion or thesis in one or a few scientific papers, in as reputable a journal as you can find, means nothing whatsoever. It just means science has taken a look at something. If you want to use publication as a method of roughly judging how likely something is to being accepted as true (because you can't judge the data yourself), then you must look at how often the idea has independently appeared. I emphasize independently because, science being run by fallible humans, it is all too common for popular ideas to be repeated in multiple papers without independent experimental verification. That's not independent publication.

Incidentally, the journalist's touchingly naive faith that an assessment of whether someone is nice or nasty, or has a "conflict of interest," or other such moralizing (not to say Inquisitorial) investigation of a researcher's motives or behaviour can function as a proxy for independent verification, is equally vacuous. It can't. Thinking that the experimenter's good or evil motives change the data he collects is magical thinking straight out of the 15th century.

Wakefield may be a bastard who fudged his data, but he may very well have been right. Or he could have been a noble underpaid crusader dedicated to saving children everywhere, with incredible standards of self honesty, and yet have been dead wrong. History is full of charlatans who were accidentally right, and honest men who were accidentally wrong. The only way to tell anything about any scientist's hypothesis is to duplicate his experiment and verify (or fail to verify) his conclusion. Until that's done, no hypothesis should be taken seriously. That's empiricism.
2.9.2009 5:43pm
Splunge:
Also, a note on the distinction between "mercury" and "thimerosol":

The chemical state of an element has profound effects on its reactivity. You're all aware, one assumes, that the table salt you so freely consume contains 40% by weight sodium -- a dangerously reactive metal that bursts into flame on contact with water -- and 60% by weight chlorine, an exceedingly toxic and corrosive chemical used in chemical warfare. But of course the sodium and chlorine ions in table salt are very different, chemically speaking, from the neutral sodium atoms and chlorine molecules in pure sodium and chlorine. Neutral chlorine molecules are reactive and dangerous. Chloride ions are chemically nearly unreactive and placid, harmless.

Similarly with mercury and other heavy metals. Pure mercury is quite toxic. But that tells you zip about the toxicity of the mercury ions in thimerosol. You might as well note that a car bearing down on you at 60 MPH is very dangerous, and conclude that one sitting peacefully in the garage is equally dangerous. Just because both are "cars" doesn't tell you enough. Similarly, just because two substances both contain the element "mercury" doesn't tell you enough to judge their relative danger.
2.9.2009 5:55pm
neurodoc:
SenatorX: How about you stop speaking for "the scientific world" neurodoc? You started the "vaccines are the safest most tested science ever" argument here years ago and yet I keep showing you new studies all the time that show how poor the science has been. What gives?
I speak as someone with relevant professional experience and nowledge, not on behalf of "the scientific world."

As for the "science" you would rely on, you place "faith" in the Geiers, pere et fils. That says all that needs to be said. (Have a look at www.neurodiversity.com, I commend it highly.)

SenatorXI regret that you take the personal umbrage at what I say that you do. I appreciate how distressing it is for you to have an autistic child and neither know the cause, nor have an effective treatment. I think you are fundamentally wrong in most of what you say about the relevant science, however. I doubt you can find a reputable child neurologist or neuroepidemiologist who would endorse a fraction of what you argue about vaccines and autism.
2.9.2009 8:17pm
neurodoc:
SenatorX: How about you stop speaking for "the scientific world" neurodoc? You started the "vaccines are the safest most tested science ever" argument here years ago and yet I keep showing you new studies all the time that show how poor the science has been. What gives?
I speak as someone with relevant professional experience and nowledge, not on behalf of "the scientific world."

As for the "science" you would rely on, you place "faith" in the Geiers, pere et fils. That says all that needs to be said. (Have a look at www.neurodiversity.com, I commend it highly.)

SenatorXI regret that you take the personal umbrage at what I say that you do. I appreciate how distressing it is for you to have an autistic child and neither know the cause, nor have an effective treatment. I think you are fundamentally wrong in most of what you say about the relevant science, however. I doubt you can find a reputable child neurologist or neuroepidemiologist who would endorse a fraction of what you argue about vaccines and autism.
2.9.2009 8:17pm
John Moore (www):
SenatorX,

The desire to find a cause for your son's affliction is understandable. However, even if one could prove vaccines as the cause (and they aren't), it wouldn't help your son at all. Yet you assert "I have a sick son and need him cured."

Which leads to the question: what does arguing about vaccines have to do with helping your son?

There are many disorders for which medicine cannot provide explanations or cures, and there are many others which are often very hard to diagnose. I wish you the best for your son, but don't blame the scientists.
2.9.2009 9:45pm
Tony Tutins (mail):

The only way to tell anything about any scientist's hypothesis is to duplicate his experiment and verify (or fail to verify) his conclusion.

True. But where does such motivation come from? Who gives grant money to duplicate somebody else's work? Which researcher has won fame by being the janitor of science?
2.9.2009 11:23pm
John Moore (www):

But where does such motivation come from?

Often from someone out to disprove the work. Science works by attempted falsification.
2.9.2009 11:25pm
Roger Schlafly (www):
SenatorX asked for more research into the causes of autism. Such research probably won't cure his son, but it may help him and others.

Splunge is right. The way to test Wakefield's hypothesis is to duplicate his experiment. Scientific research can answer these questions, not blind faith in vaccines.
2.10.2009 12:03am
Milhouse (www):
Schlafly, I'm still waiting for you to explain how your claim that there have been no deaths from measles in the USA (assuming that's true) supports your claim that Wakefield's paper did no damage.
2.10.2009 12:18am
Scote (mail):
I'm still waiting for Schlafly to explain how the 150 years of science that supports evolution is a liberal plot, one so egregious that Schlafly literally dedicates his website to fighting "Leftist Evolutionists."

Meanwhile, Schlafly tries to spread FUD, wondering aloud why anyone should care about a scientific fraud that has wasted valuable resources as scientists have had to disprove a link that never actually existed, and caused reduced vaccination rates in spite of Wakefield's fraudulent claims having been disproved by epidemiological studies. Why would Schlafly be so eager to defend this highly damaging fraud? What is Schlafly's agenda, besides fighting "Leftist Evolution?" Increasingly it seems clear that conservapedia editor Schlafly is, IMO, a Socratic Troll, who uses endless disingenuous questions to cast FUD on his ideological enemies, be they ideas or people.
2.10.2009 12:39am
Roger Schlafly (www):
Milhouse, I live in the USA which has eradicated measles. If you are concerned about getting measles, then go get an MMR shot. Or go live in a country where it has been eradicated. I don't care. I got measles once, and it was no big deal. If you think that someone somewhere in the world was somehow injured by Wakefield's paper, then post the info.

Scote, if you are interested in topics discussed on my blog, then go ahead and read it. You might learn something. I was just commenting on this Wakefield story here.
2.10.2009 2:41am
giovanni da procida (mail):
Technically Roger Schlafly is incorrect.


No one in the USA has died of measles in the last ten years since Wakefield published his infamous paper.


According to the CDC:


In 2003, two measles-related deaths were reported.


http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5331a3.htm

2003 is within the last ten years. I grant that two deaths from measles is a vanishingly small number compared to the other causes of death in the United States. But measles cases are increasing in the United States (http://www.foxnews.com/story/0,2933,354013,00.html). I don't think all people infected with measles will be lucky enough to consider it "no big deal."

I guess my questions would be, Roger, what policies did the United States utilize to eradicate measles? What policies are generally used to eradicate a particular disease?

Are there instances of diseases being eradicated without the use of mandatory vaccinations?
2.10.2009 3:10am
Scote (mail):

Scote, if you are interested in topics discussed on my blog, then go ahead and read it. You might learn something. I was just commenting on this Wakefield story here.


The reason I bring up your self-professed mission to oppose "Leftist Evolutionists" is because it demonstrates that you aren't interested in objective science, but instead consider inconvenient facts something to be opposed on ideological grounds. Such is what you are doing here, as you overtly excuse the harm and fraud perpetrated by Wakefield in your pursuit of weakening public heath programs and required vaccinations that you oppose on ideological, not scientific, grounds. Your FUD is only a way to cover your tracks...
2.10.2009 3:30am
neurodoc:
Death is not the only untoward outcome of measles, e.g., encphalitis and SSPE; death is not the major concern where rubella is concerned, rather teratogenicity is; and the non-fatal consequences of mumps can include pancreatitis and sterility in males. Even when there is complete recovery without residua of any sort, the acute morbidity imposes a great burden on not only the affected, but others around them.

Smallpox has been eradicated, that is unless bioterrorists release it. Measles has not been "eradicated," it has been controlled here in the US through vaccination. Polio is a candidate for eradication, but non-cooperation of certain populations has presented unanticipated obstacles.
2.10.2009 3:31am
giovanni da procida (mail):
neurodoc,

Thanks for the explanation of measles outcomes and also for the distinction between a disease that is controlled vs. eradicated.
2.10.2009 4:02am
Splunge:
True. But where does such motivation come from? Who gives grant money to duplicate somebody else's work? Which researcher has won fame by being the janitor of science?

You raise an exceedingly important point, one not very well understood by Congressbots and the people who elect them. You're quite right that it is increasingly difficult to get funding to merely duplicate other results, even though independent verification of results is the cornerstone of empirical science.

Fortunately, so far it has been possible to rely on the looseness with which funding is awarded, i.e. it's usually possible to divert some of the funding for X to do experiment Y, which merely duplicates someone else's work, and which, willy nilly, may significantly modify (even eliminate) one's plans to go on to X. Funding agencies as yet are not so picky that they insist the final report match the grant application closely.

But why would individual scientists, even if they have the money, waste it duplicating research? Vanity, pretty much. Often it's the case that you're a small guy, and you think the original work, by a big guy, is egregiously flawed, and accepted only because he was a big guy. You long to prove the silly idea wrong, in cold hard data, and become famous for doing so. Science really can be that cut-throat competitive.

As for winning fame through "janitorial" service -- plenty of people have become famous through destroying or firmly verifying novel ideas. Michelson, for example, thought relativity was a load of hooey and dedicated decades of his life to proving Einstein wrong. In his lifetime he became famous as the first with very strong evidence, cited in all the standard textbooks, that Einstein was right. Joule became famous (and gave his name to the SI unit of energy) for precise measurements that proved the equivalence of work and heat that others had merely speculated about. And so on.

Scientists treasure solid proof more than clever ideas or ingenious arguments. That's why we're scientists, and not, say, lawyers. Clever ideas are ubiquitous and cheap. Everybody has 'em all the time. Just check out the comments section on any blog. Solid proof that kills certain ideas flat dead, or puts others into near indisputability, is rare and golden. So being a successful "janitor" is very appealing to the scientist ordinary.
2.10.2009 4:21am
jukeboxgrad (mail):
aubrey:

I was happily ignoring you and you got me back in


I'm terribly concerned. Your happiness is my top priority.

Uh, no. You got yourself back in. No one is holding a gun to your head and forcing you to read posts or respond to posts. Mine or anyone else's. When you choose to further humiliate yourself, the choice is all yours.

You recall the sanctions killing half a million a year.


Someone made that claim? Really? I realize that asking you for a citation would be expecting way too much.

That lefty rag the Nation said this:

the most likely number of excess deaths among children under five years of age from 1990 through March 1998 [is] 227,000


So you're only exaggerating by a factor of roughly 18.

You might be thinking of an earlier claim: "that sanctions were responsible for the deaths of 567,000 Iraqi children." But that claim was regarding a period of several years. Let us know when you're ready to show us an example of someone claiming "the sanctions [killed] half a million a year."

Anyway, you pick your poison: If the sanctions foes lied, then the death rate might be accurate.


Even if someone had made the incorrect claim that "the sanctions [killed] half a million a year," that has nothing to do with Lancet (unless they made that claim, and of course they didn't).

And I guess you think no one notices that you're moving the goal posts. Your original claim was not that the death rate is incongruent with the claims made by "the sanctions foes." Your original claim was that the death rate was wrong, period. But of course the one who is wrong, as usual, about nearly everything, is you.

Please continue to invent your own facts (as you have done many, many, many times before). Perhaps some readers come here to read fiction, and you deliver a reliable supply.
2.10.2009 8:40am
Antaeus Feldspar (mail):
Splunge --

I agree with everything you said in your 5:43 pm post, except for this paragraph which I actually thought was from Schafly until I looked more closely:

"Incidentally, the journalist's touchingly naive faith that an assessment of whether someone is nice or nasty, or has a "conflict of interest," or other such moralizing (not to say Inquisitorial) investigation of a researcher's motives or behaviour can function as a proxy for independent verification, is equally vacuous. It can't. Thinking that the experimenter's good or evil motives change the data he collects is magical thinking straight out of the 15th century."

You set up a false dichotomy here: either an experimenter's data is so completely controlled by his motives that "investigation of a researcher's motives ... can function as a proxy for independent verification", or an experimenter's data is never changed by the motives he has for collecting the data in the first place. Neither of these false choices is correct.

Every scientist and student of science -- really, every responsible person -- should educate themselves about cognitive biases. Cognitive biases mean that even if we make every conscious effort possible to be completely honest about what we perceive, what we perceive will still be affected by what we expect to perceive and what we hope to perceive. Standing to make a huge financial gain if your tests produce certain results does significantly increase the chances that you will see those results in data where someone else would not see them.

Is the existence of such a bias proof that the data has been distorted? Of course not, but it is a significant risk factor -- so significant that any so-called scientist who deliberately withholds the existence of such a risk factor, as Wakefield did, has committed a significant violation of public trust.
2.10.2009 9:20am
Richard Aubrey (mail):
juke.You are good. Shifty, but good.
The Lancet didn't refer to, didn't need to refer to the accusations about sanctions.
You need a lot of kids to have a death rate that low--quoth juke--and sanctions removed the kids from Iraq at a rate unseen in recent history.
Or not.
Either the sanctions foes were lying or the Lancet was fooled, or lied, in its pre-invasion claim of a low death rate.
There is no connection between Lancet and sanctions foes.
Simply that only one, at most, can be right.
2.10.2009 11:50am
Dan Weber (www):
Splunge is right. The way to test Wakefield's hypothesis is to duplicate his experiment.

Now that we have the source data we know his experiment was incorrect.

In addition, he may also be a complete scam artist. The alternative is that he's an incompetent scientist.

Note that the fact that he's incompetent or a fraudster isn't what proves his experiment incorrect. It's the fact that looking at the source data shows his experiment was completely wrong.

Scientific research can answer these questions, not blind faith in vaccines.

Non sequitur. Vaccines have nothing to do with autism. You might as well say "we need scientific research into autism, not blind faith in magnetic fields."
2.10.2009 11:59am
jukeboxgrad (mail):
aubrey:

Shifty, but good.


Are you going to cite any proof? Of course not. Meanwhile, I've cited plenty of proof that "Shifty" is your middle name.

Either the sanctions foes were lying or the Lancet was fooled


The liar is you, because you made a false claim about what was said by the "sanctions foes." And you are being scrupulously consistent with your past behavior in refusing to take responsibility for your false claim.

There is no connection between Lancet and sanctions foes. Simply that only one, at most, can be right.


If there were actually any "sanctions foes" who made the claim that you claim they made, they would indeed have been wrong. But this is entirely irrelevant to what Lancet said. And aside from that, you haven't managed to produce a single example of "sanctions foes" making the claim that you claim they made. But I hope you and your little straw man are having lots of fun together.
2.10.2009 12:27pm
neurodoc:
giovanni da procida: Are there instances of diseases being eradicated without the use of mandatory vaccinations?
Malaria in the United States. Hard to believe today, but that was a possibility at one time here in our nation's capitol.
2.10.2009 1:17pm
neurodoc:
I don't wish to join that "converation" between Richard Aubrey and jukeboxgrad, but I will just observe in passing (hopefully) that the Lancet not infrequently ventures into something uncommon in medical/scientific, that is the politically tendentious, e.g., beating up on Israel. Probably unrelated to the Wakefield matter, but arguably goes along with lower standards for publication.
2.10.2009 1:23pm
jukeboxgrad (mail):
You can join our converation anytime you want to.
2.10.2009 1:39pm
jukeboxgrad (mail):
But don't expect a friendly answer if you ask me nosy questions about my "converation rate."
2.10.2009 1:42pm
Scote (mail):

neurodoc:


giovanni da procida: Are there instances of diseases being eradicated without the use of mandatory vaccinations?



Malaria in the United States. Hard to believe today, but that was a possibility at one time here in our nation's capitol.


But the DDT spraying was mandatory...

Malaria is a disease where we can attack the vector, the mosquitoes through mosquito abatement. Not so with measles or other childhood diseases we have vaccines for.

So, if Schlafly tries to use Malaria as proof that mandatory vaccinations aren't necessary to fight measles, he'll be off in left field (snicker...)
2.10.2009 1:54pm
Roger Schlafly (www):
Scote, your position here seems to be that you favor mandatory measles vaccination, and you want to criminally prosecute Wakefield who published a hypothesis that caused some people to question the vaccine safety. If you were to get your way, then people would be forced to get medical treatment without access to info about the risks and benefits of the treatment.
2.10.2009 4:51pm
Dan Weber (www):
I don't know if Wakefield should go to jail; what he did sounds more like the "crime-facilitating speech" that Orin loves to talk about.

Most of the people who are injured were idiots who refused to listen to the scientists explaining why Wakefield's study was wrong and actively participated in the foolishness.

A few were innocent victims, like the less-than-one-year-old who got exposed to measles because some upper-class parents thought it would be fashionable to not immunize and then take trips to Europe.

Ruining It For The Rest Of Us

Probably the bigger victim of Wakefield is the autism community, which has wasted shitloads of time and money investigating a useless lead, based on a shoddy study that we now know was probably an active fraud.

I'm not sure there's anything criminal in publishing a fraudulent study when you have an undisclosed financial stake in the outcome. It's the kind of thing that makes people say "there oughtta be a law" but that doesn't mean there is one.
2.10.2009 5:16pm
John Moore (www):
There is a civil liberties balancing act in all of this.

The risks of vaccination may outweigh the advantages for an individual, while the risks of an unvaccinated population are unacceptable to both that individual and others.

In that case, it becomes sort of an inverse "tragedy of the commons" issue.
2.10.2009 6:09pm
SenatorX (mail):
We went to lots of "reputable" doctors in multiple states who all (after a year of saying "he is just a boy" or "its ear infections") said there is no cure and we have to deal with it forever. They proscribe ABA behavioral therapy which while it was paid for the by the state we took. They blink and say nothing when you ask what behavioral psychology is going to do for his gut issues (or why the brains of autistics swell).

After another year of this and no change we attempted severe diet restriction of no gluten or casein and the results were positive almost immediately. We then realized the "reputable doctors" were not necessarily the "best doctors" for our son. After hunting we found a DAN doctor who began treating him for basically vaccine damage. Inflammation, immune problems, metabolic issues and diet with the appropriate supplements to fill in for the certain things he couldn't eat. Since then he has been a straight shot of recovery unlike other kids in his class whose parents follow their "reputable doctors" advice.

We had another son a month ago and we are not vaccinating. We shall have to see if he gets regressive autism like our first. Our DAN doctor says of the 350+ families he sees not a single repeat of autism for any of the unvaccinated children born to parents of an autistic.

There are no refutations here. This is not science. But its not fantasy either. The current official treatment for autism is purely behavioral. There is no acknowledgement at all of the bio-medical aspects of the problem. No attempt to even explain why autopsies of autistics show inflamed brains. No explanation of the gut issues. This shows a problem with the "reputable doctors".

neurodoc your problem can be summed up as follows : you make your money on people respecting your authority therefore you love authority and hate things that do not respect authority. This is a filter of your psyche.
2.10.2009 7:24pm
John Moore (www):
SenatorX

I too have had many problems with doctors failing to make correct diagnoses or cure. The difference is that I understand the difficulties of that - an understanding which is very helpful in eventually getting results.

You, on the other hand, are blaming these doctors and impugning their abilities. Well, you're right- they're not miracle workers - they have a very tough job in a very junior science.

As for your DAN doctor with his "vaccine damage" - how much peer review shows that it works? What is "vaccine damage?" Is there an animal model? Is the biochemistry understood? Is it a defineable disorder?

It is possible that his treatment helps. All sorts of things help, or appear to help - especially in unusual illnesses.

It is also true that, rarely, the paradigm of a disease is overturned - for example the discovery that ''Helicobacter Pyloris'' is the primary cause.

However, your anecdotes prove absolutely nothing other than you do not understand scientific inquiry, or are too emotional on this issue to apply reason..
2.10.2009 7:35pm
neurodoc:
Roger Schlafly: Scote, your position here seems to be that you favor mandatory measles vaccination...If you were to get your way, then people would be forced to get medical treatment without access to info about the risks and benefits of the treatment.
Jacobson v. Commonwealth of Massachusetts is still good law more than 100 years later, isn't it?

SenatorX: neurodoc your problem can be summed up as follows : you make your money on people respecting your authority therefore you love authority and hate things that do not respect authority. This is a filter of your psyche.
If you chose "faith" over science and would rely on the Wakefields, Boyd Haleys, Geiers, Gary Nulls, and other charlatans and fraudsters, that is your perogative.

Scote:
But the DDT spraying was mandatory...

Malaria is a disease where we can attack the vector, the mosquitoes through mosquito abatement. Not so with measles or other childhood diseases we have vaccines for.
I think that malaria was pretty much vanquished in the United States, at least in the Washington, DC area, well before the advent of DDT as an insecticide.

Yes, the most effective way to prevent malaria is by controlling the insect vector (draining swamps, spraying with DDT, etc.) and/or keeping humans from being bitten (mosquito-proof netting over beds). There have been rare instances of malaria after individuals infected with malaria (returning Vietnam vets) came to places previously free of malaria (around the VA hospital in Hines, IL), were bitten by mosquitoes, and those mosquitoes then transmitted the infection to others.

Presently, of course, there is no effective vaccine against malaria, though much work has gone into coming up with one. I just threw out malaria in response to the question whether any disease had ever been "eradicated" without the use of vaccines, and this one occurred to me. Undoubtedly, there are more apt examples for these purposes, they just didn't occur to me. (And I don't imagine there is any way to cut off absurd claims and arguments by Roger Schlafly, so I see no reason to try.)
2.10.2009 9:55pm
Scote (mail):

I think that malaria was pretty much vanquished in the United States, at least in the Washington, DC area, well before the advent of DDT as an insecticide.


A very good point. Mosquito abatement by eliminating standing water, and other measures, preceded DDT, and was a key to making DC livable. I'm not sure if DDT was used in DC after it's use became widespread, but I'll make a guess that it was to some degree.

But, it seems that malaria, while nearly eradicated in DC, is not completely so, as this incident seems to refer:



Two cases of Plasmodium vivax malaria near the US capital seem to have been acquired locally from indigenous malaria carrying mosquitoes breeding in the area, not from malaria carrying mosquitoes escaping from Dulles international airport.


But, I don't think that rare incident rebuts your point, either.

Meanwhile, Wakefield is a scientific fraud who's fraud has wasted millions of dollars chasing fraudulently created phantom links, millions that could have been put to use finding the **actual** causes of autism rather than the cause that Wakefield and the antivaccination lawyer who employed him needed for planned lawsuits. A fraud that self-professed enemy of "Leftist Evolution, "Roger Schlafly, defends.
2.10.2009 10:53pm
Roger Schlafly (www):
Scote, you have now called Wakefield a fraud 31 times in this thread. I am not defending fraud, and I have no way of assessing the allegations against him. But whether he is a fraud or not, it would not tell us the cause of autism. I support scientific research, not silly vendettas against those who challenge conventional wisdom.
2.11.2009 12:57am
John Moore (www):
Frauds and cranks, especially in medicine, can do a tremendous amount of harm. They cause people to distrust real experts, cause them to place false hopes and blames, enrich greedy lawyers, cause folks to waste money, and confuse the issues.

Autism is a tragedy. It has an unknown cause AFAIK. It is human nature that those affected by it would seek a cause for it.

The same phenomenon is common with certain kinds of cancer, where activists proclaim "cancer clusters" and then cast about for causes (usually "evil" corporations and the trace amounts of residue the leave behind). Almost all controversial cancer clusters are purely statistical fluctuations - completely predicted by random statistics.

Unfortunately, this sort of quest opens the door for frauds and cranks, as it has for centuries for all sorts of disorders.

Only rarely does the dissenter turn out to be right.
2.11.2009 1:13am
Scote (mail):

Roger Schlafly (www):
Scote, you have now called Wakefield a fraud 31 times in this thread. I am not defending fraud, and I have no way of assessing the allegations against him. But whether he is a fraud or not, it would not tell us the cause of autism. I support scientific research, not silly vendettas against those who challenge conventional wisdom.


I'd say that you have no **interest** in assessing the allegations against Wakefield. You love claim you are just interested in scientific research, yet you continually ignore any such research when people point to studies that show that there is no link between MMR and Autism. What you seem to be interested in is perpetuating the false links that Wakefield's fraud (who hoo! 32) has caused, and condoning the waste of resources his fraud (33!) has caused when researchers have had to try and replicate his fraudulent (34!) results to--money that could have been used to investigate real links rather than those made up by a fraud (35!). IMO. (And, yes, all mentions of "fraud" by me in this thread are my opinion, but one that looks to be eminently justified, unlike your curious claims of mystification over the issue.)

One thing is clear, though, you, the self-professed enemy of "Leftist Evolutionists," don't see science as being objective, instead you see science as an ideological tool. Speaking of ideological tools...
2.11.2009 4:01am
neurodoc:
Scote: And, yes, all mentions of "fraud"...
What, you can't count past 35?

With regard to the cause(s) of autism, I should have said that the majority thinking among neuroscientists is that the die was cast for these unfortunate children before they were born, that is before any vaccines were ever given. (Of course, no one has shown that unvaccinated children are at greater risk of autism than those who do get vaccinated.) Hey, but what do those neuroscientists know in comparison to what is known with certainty by the likes of Gary Null (http://www.quackwatch.org/04ConsumerEducation/
null.html), the Geiers (http://neurodiversity.com/weblog/article/114/
pharmaceutical-cornucopia), and others of that ilk.

[Thanks for the link to that BMJ piece about malaria here in the DC area. Those exceptional 2 cases mentioned there are indeed what I had in mind.]
2.11.2009 10:55am
neurodoc:
...I am not defending fraud, and I have no way of assessing the allegations against him.
Most of us would say there is more than enough evidence upon which to conclude that Wakefield is a fraudster. And we have our suspicions about those who would say otherwise, especially when they do so while going on about so much other arrant nonsense. (www.darkbuzz.com)
2.11.2009 11:02am
Dan Weber (www):
But whether he is a fraud or not, it would not tell us the cause of autism.


What I'm gonna say has been said a few times already, but I'll spell it out very explicitly.

It's not "Wakefield is a fraud, therefore his research is wrong."

It's "Wakefield's research is wrong. In addition, he is most likely a fraud."

The underlying data directly and obviously contradicts Wakefield's hypothesis. (He said "these 12 kids first showed autism symptoms within a week of getting MMR shots." Most of the kids had prior records of autism symptoms going back months before the MMR shots.) I suppose it's possible that he's just massively incompetent.
2.11.2009 11:22am
Roger Schlafly (www):
Dan, suppose I agreed with you. Wakefield's hypothesis has turned out to be incorrect, and after 10 years of analysis, there are questions of methodology that suggest that he was a fraud or incompetent. Why would anyone care? I base my decisions on objective science. Wakefield's study was an insignificant study of 12 kids in 1998. All it did was to suggest from future research. Do you want to suppress anyone who presents a dissenting view about vaccines? Do you think that it was wrong for anyone to even suggest a link between MMR and autism? If Wakefield triggered some people to do some vaccine safety studies, so much the better.
2.11.2009 1:21pm
Dan Weber (www):
Do you think that it was wrong for anyone to even suggest a link between MMR and autism?

Scientifically wrong? Well, there is and was no link, so it was scientifically wrong.

Morally wrong? Yes, I think it is morally wrong for someone to commit fraud and publish invalid studies and give people false medical advice in order to personally profit.

Now, if someone had done good honest research but accidentally came to the incorrect conclusion that autism had something to do with MMR. that would be morally okay. Of course, Wakefield massively fails this test.

If Wakefield triggered some people to do some vaccine safety studies, so much the better.

No. The money wasted researching vaccines would have been better spent on, well, anything. Say, actual autism research.
2.11.2009 3:54pm
neurodoc:
Roger Schlafly: All it did was to suggest from (sic) future research...If Wakefield triggered some people to do some vaccine safety studies, so much the better.
Totally debunked, probably fraudulent science suggesting future research undertakings?!

Roger "I support scientific research" Schlafly thinks because even blind squirrels discover the occasional acorn notwithstanding their visual impairment, the way to find acorns is to set great numbers of blind squirrels loose to look for them, sparing no expense in support of their efforts. (If you want more Shakespeare rather than more science, then of course you should buy millions of IBM Selectric typewriters and put monkeys to work turning out copy, which sooner or later will include something equal to the Bard's efforts, maybe something even better.)

The main switchboard number for the National Institutes of Health is 301-496-4000. Operators are standing by. Call now to give them your mailing address, so they can get the grant checks out to you in tomorrow's mail.
2.11.2009 5:42pm

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