BMJ: Article on Ben Goldacre and responses (Autsim/MMR/Wakefield)

[Guest guest]

Can only get an extract - anyone have whole article?

Also below the following extract are the BMJ responses.

http://www.bmj.com/cgi/content/extract/337/oct01_3/a1856

Published 1 October 2008, doi:10.1136/bmj.a1856

Cite this as: BMJ 2008;337:a1856

Views & Reviews

Review of the Week

Becoming Ben

, director, Ovations Chronic Disease Initiative

richardswsmith@...

Ben Goldacre’s book assembles an impressive array of villains

who deal in bad science, finds

The first 150 words of the

full

text of this article appear below.

We’re lucky to have Ben Goldacre, and maybe as a result

of his book we’ll have more people like him. He is fighting

what sometimes seems like a one man battle against a tide of

pseudoscience and an army of quacks. His main weapons are his

weekly column in the Guardian newspaper, an impressive

website

(

www.badscience.net), and now this book, which aims " to

teach good science by examining the bad. "

Luckily Goldacre, a practising doctor, has all that’s

needed for the battle: a solid understanding of epidemiology,

statistics, and public health; a fluid, engaging way of

writing, although with a weakness for bad jokes; a gift for

using the web effectively; a taste for glory; a thick skin;

good lawyers; and seemingly boundless energy (he tells us in

passing about his childhood hyperactivity).

The good lawyers are necessary because Goldacre is regularly

threatened with libel actions and even . . .

[Full

text of this article]

http://www.bmj.com/cgi/eletters/337/oct01_3/a1856

The MMR story is not complete

8 October 2008

Stone,

none

London N22

Send response to journal:

Re: The MMR story is not complete

I should like to ask [1] how it could

be that Ben Goldacre's account of the MMR story is complete when it has

been made virtually impossible, particularly in this country, for those

on one side of the debate to present their case, not least because

proponents of MMR safety blank all criticisms? Meanwhile, and for long

time the media - so far from supporting or giving space to

Wakefield - have been largely intimidated into silence.

As it is Goldacre has never answered the challenge of the fundamental

flaws in the epidemiology of MMR and autism, as, for instance, I set out

for him in my Rapid Response of 21 September 2007 [2], citing four

studies he had used in his pivotal award winning polemic 'Never Mind the

Facts', published in the Guardian in December 2003 [3]. Three of the

studies, I pointed out, were found when reviewed by Cochrane to be

seriously deficient. In fact none of the six autism studies reviewed by

Cochrane was judged to be of low risk of bias (and these were supposed to

be the best). Cochrane demonstrated its own bias by suggesting that the

absence of evidence for safety should be balanced against the need to

eradicate the diseases, [4] [5] stating in conclusion:

" The design and reporting of safety outcomes in MMR vaccine studies,

both pre- and post-marketing, are largely inadequate. The evidence of

adverse events following immunisation with MMR cannot be separated from

its role in preventing the target diseases. " [4]

Moreover, it is less than certain that even if the epidemiology had been

better conducted than it has been whether it would have necessarily given

a clear answer regarding Wakefield's hypothesis. Almost unreported in

this country the former head of the National Institutes of Health,

Bernardine Healy, told CBS news earlier this year that the Institute of

Medicine Review of 2003/4 had been over-dependent on epidemiology, and

that in order to properly research the autism/vaccine issue you would

have to look at medical subgroups (as, indeed, Wakefield had been

doing)[6].

Also, almost unreported in this country has been the publication of the

Hornig study [7], the first study to even half heartedly replicate the

Uhlmann study of 2002, which layed out Wakefield and O'Leary's initial

laboratory findings [8]. While the rhetoric surrounding the publication

of the Hornig study has trumpeted in the US the final eclipse of the

Wakefield hypothesis the interior detail suggests anything but (perhaps

why we have heard so little of it so far in this country).

In the first place the study confirms the consistency of O'Leary's

results with two most higly rated labs in the US. Secondly, while the

study only had five cases which of the Wakefield pheno-type it confirmed

two positive results for measles virus RNA from ileal samples, across all

three laboratories - one from the autistic group and one from the control

group, all of which had gut pathology (and all cases having MMR). The

study does not tell us whether symptoms in two cases developed pre or

post vaccination, though it would certainly bolster their case for

" lack of association " if it was pre. And so far from disputing

the results Uhlmann in the discussion it states:

" Our results differ with reports noting MV RNA in ileal biopsies of

75% of ASD vs. 6% of control children [10], [41]. Discrepancies are

unlikely to represent differences in experimental technique because

similar primer and probe sequences, cycling conditions and instruments

were employed in this and earlier reports; furthermore, one of the three

laboratories participating in this study performed the assays described

in earlier reports. Other factors to consider include differences in

patient age, sex, origin (Europe vs. North America), GI disease, recency

of MMR vaccine administration at time of biopsy, and methods for

confirming neuropsychiatric status in cases and controls. Participation

in the current study required confirmation in cases of the presence of an

AUT diagnosis and exclusion in controls of AUT or other developmental

disturbances. "

Another reason why we might find this troubling in this country is that

study confirms the appropriateness of the kind of investigation for which

Drs Wakefield, - and Murch are presently on trial at the

General Medical Council. Not only is this a terrible injustice to the

doctors - irrespective of whether the hypothesis is correct or not - but

it has effectively infringed the rights of autistic children in this

country who are now widely being denied appropriate medical support, as

the National Autistic Society has warned [9].

[1] , 'Becoming Ben', BMJ 1 October 2008,

http://www.bmj.com/cgi/content/full/337/oct01_3/a1856

[2] Stone 'Re: Restrictions on hospitality apply to doctors and

journalists', BMJ Rapid Responses

http://www.bmj.com/cgi/eletters/335/7618/480#176662

[3] Ben Goldacre, 'Never mind the facts', Guardian 11 December 2003:

http://www.guardian.co.uk/life/feature/story/0,,1103958,00.html

[4] V Demicheli, T Jefferson, A Rivetti, D Price,[Review] 'Vaccines for

measles, mumps and rubella in children', Cochrane (Wiley 2005),

http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD004407/frame.html

[5] Clifford G , 'Questions on the Independence and Reliability of

Cochrane Reviews, with a Focus on Measles-Mumps-Rubella Vaccine',

http://www.jpands.org/vol11no4/millerc.pdf

[6] CBS News,'Leading doctor: vaccines-autism worth study',

http://www.cbsnews.com/stories/2008/05/12/cbsnews_investigates/main4086809.shtml

[7] Mady Hornig, Briese, Buie, Margaret L. Bauman,

Lauwers, Ulrike Siemetzki, Hummel, A. Rota, J.

Bellini, J. O'Leary, Orla Sheils, Errol Alden, Larry Pickering, W.

Ian Lipkin, 'Lack of Association between Measles Virus Vaccine and Autism

with Enteropathy: A Case-Control Study', published 4 September 2008,

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0003140#s3

[8] V Uhlmann, C M , O Sheils, L Pilkington, I Silva, A Killalea, S

B Murch, J -, M Thomson, A J Wakefield, and J J O'Leary,

'Potential viral pathogenic mechanism for new variant inflammatory bowel

disease', Molecular Pathology, Mol Pathol. 2002 April; 55(2): 84–90,

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed & pubmedid=11950955

[9] NAS, 'General Medical Council hearing against Dr Wakefield',

http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=459 & a=13952

" The National Autistic Society (NAS) is keenly aware of the concerns

of parents surrounding suggested links between autism and the MMR

vaccine. The charity is concerned that the GMC hearing, and surrounding

media coverage, will create further confusion and make it even more

difficult for parents to access appropriate medical advice for their

children.

" It is particularly important that this case is not allowed to

increase the lack of sympathy that some parents of children with autism

have encountered from health professionals, particularly on suspected gut

and bowel problems. Parents have reported to the NAS that in some cases

their concerns have been dismissed as hysteria following previous

publicity around the MMR vaccine. It is crucial that health professionals

listen to parents' concerns and respect their views as the experts on

their individual children.

" There is an urgent need for further, authoritative research into

the causes of autism, to improve our understanding of the condition, to

respond to parents' concerns and to enable us to ensure that there are

appropriate services and support in place to meet people's needs. "

Competing interests: Autistic son

Becoming Ben.

10 October 2008

Bill Welsh,

President

ATT clinic, 29A Stafford street, Edinburgh EH3 7BJ

Send response to journal:

Re: Becoming Ben.

The MMR “debacle” as Ben Goldacre describes it is far

from over. " The blame " does not lie with “hundreds of

journalists” etc, it lies fairly and squarely with a highly politicised

health system that discourages dissent from within its own ranks, that

combined with a greed philosophy that has enveloped a once fine

profession. It may be of interest to BMJ readers to learn of some of the

glowing descriptive terms used at the ongoing GMC trial of Dr Wakefield

et al, with regard to their scientific research: “excellent”, “robust and

rigorous”, “revolutionary”, “watertight”, “clinical observation backed up

by good science”, etc, etc. I could go on but when I tell you that these

quotes are from prosecution witnesses you will realise how far off the

mark ‘Becoming’ Ben is in his attacks on the witness of thousands of

parents. And that is what the MMR debate has become, a battle between

ordinary citizens whose children face 70 years of mental handicap and

pain, and people like Goldacre. This is no longer about good science or

bad science, the science debate was over when the editor of the Lancet,

Horton, recently conceded re Wakefield’s paper, and I quote: 'The

essential clinical findings remain unchallenged as far as their accuracy

is concerned'. Perhaps Horton can encourage Goldacre “to a deeper

understanding of this complex issue”.

Competing interests: Grandfather of an autistic boy.

The Dawn of

McScience 10 October

2008

Mark Struthers,

General Practitioner

Bedfordshire, UK

Send response to journal:

Re: The Dawn of McScience

The sun has set on honest, independent science whose

primary goal is the discovery of truth. I don’t know when the sun went

down, but like Horton, I do know that a new era has dawned.

Of course, Dr Horton, present esteemed editor of The Lancet, described

the enlightenment of this new dawn in his book on the MMR crisis. [1] In

the third chapter, Horton eloquently describes how, with the colonization

of science, the traditional norms of disinterested inquiry and free

expression of opinion have been given up to the harvest of huge revenues

from the global wellness industry. He tells us that “subtle yet insidious

changes to the rules of engagement between science and commerce are

causing incalculable injury to society, as well as to science.” And in

the description, Horton subtly implies that Wakefield, apparently

burdened with enormous financial conflicts of interest in his researches

into the possible causes of autism and childhood bowel disease, was an

important marker of this malignant process.

We will all remember that Wakefield and paediatricians Professors

- and Murch are currently being tried by the GMC, a trial that

will last nearly two years at a cost to the ordinary doctor of millions

of pounds.

Wakefield, who dared to question the rights of the vaccine-

industrial-complex has recently said,

“It is not a question of not vaccinating. I’m not against vaccinations. I

don’t know for sure vaccines cause autism but I suspect they do. The

opposition just states categorically it does not. But they don’t know

either.” [2]

By apparently invoking the good offices of the new corporate science, Ben

Goldacre can sneer “unattractively” at the idea of a possible link

between autism, bowel disease and vaccines, particularly the MMR.

[1] The Dawn of McScience. Horton. 3rd Chapter, MMR Science

& Fiction, Exploring the Vaccine Crisis. Granta Books 2004.

[2] Autism Doc claims government led witch hunt against him. Phil

Doherty, Sunday Sun. Sep 28 2008.

http://www.sundaysun.co.uk/news/north-

east-news/2008/09/28/autism-doc-claims-government-led-witch-hunt-against-

him-79310-21915131/

Competing interests: None declared

--------------------------------------------------------

Sheri Nakken, former R.N., MA, Hahnemannian

Homeopath

Vaccination Information & Choice Network, Nevada City CA & Wales

UK

Vaccines -

http://www.wellwithin1.com/vaccine.htm

Vaccine Dangers & Homeopathy Online/email courses - next classes

Sept 10, 2008