Orac is the nom de blog of a (not so) humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. (Continued 
Curse you, Mark and David Geier.
I'm getting tired of having to subject my scientific and critical thinking skills to the assaults on science and reason that you routinely publish in dubious journals to use as weapons in your apparently never-ending crusade to extract as much money as possible out of vaccine manufacturers and the Vaccine Injury Compensation Program. Dissecting your pseudoscientific claims causes me pain, not so much that I'm driven to take a hiatus from blogging, as Matt was by Kent Hovind's creationism, but almost.
I had hoped to let this cup pass, given how much I've written on the topic lately, but, thanks to mentions by Clark, RW, and Tara, I find myself feeling obligated to comment.
Yes, Mark and David Geier, that father-son team of dumpster-diving pseudoscientists and promoters of chelation and chemical castration as treatments for autism dedicated to "proving" that mercury in vaccines causes autism, no matter how much they need to torture the data to do it, are at it again.
This time around, they've published an allegedly scientific paper entitled Early Downward Trends in Neurodevelopmental Disorders Following Removal of Thimerosal- Containing Vaccines, published (where else?) in that repository of dubious medical science, The Journal of American Physicians and Surgeons. This paper purports to show that autism rates have started to dip since early 2003, when the last lots of thimerosal-containing childhood vaccines expired, the point after which, with the exception of some flu vaccines, for all intents and purposes no child in the U.S. has received thimerosal-containing vaccines. If true, such an observation would represent compelling evidence for the thimerosal-autism hypothesis. Not surprisingly, loony sources like WorldNut Daily and Vox Day (to whom I administered a blog slapdown a few months ago when he uncritically parroted Dan Olmsted's credulous reporting on a poorly documented population that is claimed not to have been vaccinated and to have very low rates of autism) have trumpeted the Geiers' study as "proof" that mercury in vaccines causes autism).
It's no such thing.
What it is, in actuality, is yet another example of the Geiers mining the Vaccine Adverse Events Reporting System (VAERS) database for purposes for which it was never designed and misusing the California Department of Developmental Services (CDDS) database similarly. First, off, as I pointed out extensively before, the VAERS database is designed only as an early warning system for reporting adverse events thought to be due to vaccines. It is not designed to track the incidence or prevalence of vaccine complications. One reason is that anyone can make entries into it, not just medical professionals, and the results are only checked in the most perfunctory way. For example, as Jim Laidler described before, it takes entering something like a claim that a vaccine turned one into The Incredible Hulk in order to get the staff there to question the entry. Worse, as I described before, the database has been corrupted by litigation, with a dramatic increase of entries linked to litigation claiming that thimerosal caused the plaintiff's child's autism. As for appropriate uses of the VAERS database, here's what it says right on the VAERS information page:
VAERS data are derived from a passive surveillance system and represent unverified [emphasis mine] reports of health events, both minor and serious, that occur after vaccination.
And:
While some events reported to VAERS are truly caused by vaccines, others may be related to an underlying disease or condition, to drugs being taken concurrently, or may occur by chance shortly after a vaccine was administered.
And:
Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.
The bottom line is that the VAERS database is not a reliable source to determine autism prevalence or incidence, period. It's too prone to being affected by scares, like the recent hype over mercury supposedly causing autism, and even outright manipulation, and its entries aren't even examined by medical professionals in sufficient detail to determine whether adverse events reported were or could be reasonably inferred to have resulted from vaccines. Of course, that never stopped the Geiers from diving into that database again and again and again, all without acknowledging the shortcomings of this database. And it actually wouldn't be all too surprising if reports of autism attributed to vaccines in the VAERS database did indeed fall after 2003, given that it was widely publicized that thimerosal was removed from nearly all childhood vaccines around that time, making it less likely after then that parents would attribute their children's autism to vaccines.
But what about the CDDS? It could be a source of determining whether autism rates are indeed rising, at least in California. There's just one problem. To do that properly, one has to look at new diagnoses. However, the CDDS database reports total cases (both new and old) every month. As Citizen Cain pointed out while criticizing David Kirby's misinterpretation of the California numbers last year:
Rather, the California Department of Developmental Services reports on the total number of people with autism registered to receive services. Kirby derives an estimate of children who enter the system in 2004, for instance, by subtracting the total number of cases within the system at end of 2003 from the total number of cases in the system at the end of 2004. Kirby calls the change in total cases "new autism diagnoses," which it is not.
However, as has been pointed out by Interverbal and Citizen Cain, the CDDS does record some other data that might be useful, such as age. Thus, although the purpose of this database is not to measure the incidence of developmental conditions like autism and mental retardation, in the case of autism one could get perhaps get a rough idea of the incidence of autism by looking at the cohort from 3-5 years of age over time, as this is the age range at which autism is most commonly first diagnosed. Of course, a number of potential sources of bias and error need to be kept in mind, as Interverbal described in detail, but one might get some useful information if one did the proper analysis and qualified it with the limitations of the database, a rough estimate of autism rates over time. Too bad that is not what the Geiers did.
So what did the Geiers do? I quote their paper:
The total new number of autism reports received by the CDDS from 36 consecutive reporting quarters (from that starting on January 24, 1994, through that ending on January 6, 2003), and for 15 consecutive reporting quarters (from that starting on January 3, 2002, through that ending on October 4, 2005) were analyzed.
Bzzzt! Wrong answer. (In fact, if you look at the graph on Figure 3, the Geiers even make the mistake of labeling what they are plotting as new cases of autism.) In fact, when correctly analyzed, the California data show new cases of autism in the 3-5 year old cohort continuing to rise.
Even if the data from these databases were more useful for determining the incidence of autism, the way the Geiers did their analysis is utterly laughable. Here's what they did. (Any statisticians, please chime in here.) Basically, they plotted the data as cases against time period by quarter and then used a statistics package to do linear regression of the data from 1994 to the end of 2002 and then to do it again from the beginning of 2002 until October 2005. They then compared the slopes of the two lines derived from linear regression for each graph and concluded that the slope of the line after 2002 had changed from positive (increasing) to negative (decreasing).
Geez, couldn't these guys at least have bothered to hire a biostatistician? (Certainly no statistician is listed in the authors, just Mark and David Geier.) If they had, they would have found out that doing interrupted time series analysis is fraught with difficulty, and that the appropriate way to look at such effects over time is not by simplistically comparing slopes before and after a time point, but rather by using one of these techniques, depending upon the specific question and data. Also, choosing the end of 2002 is a bit of a stretch; after all, autism is most commonly diagnosed between ages 3-5, which means that around now is the period in which we should start to see a dramatic drop in autism rates if mercury in vaccines is truly the cause of autism. But it's still even worse than that, so bad that it's funny. Basically, what the Geiers have done is to take contiguous data and make up trendlines to "prove a point," even if the data don't support it, and it's hard not to note that the r-squared value of the latter data is very much lower than the r-squared for the earlier data, meaning a much poorer fit to the linear regression. Indeed, Bartholemew Cubbins has made a useful video to show you why this is an invalid statistical technique, and Autism Diva has described it. In addition, they use the Kruskal-Wallis statistic to compare trend lines, but the K-W statistic is generally not used for that purpose. Rather, it is a nonparametric (to be used for non-Gaussian distributions) to compare the medians of three or more unpaired groups, not two slopes, one before and one after a time point. I may not be a statistician, but even I know that. This is freshman-level statistics.
Finally, let's take a look at the journal in which this "study" was published, namely The Journal of American Physicians and Surgeons (JAPS). Those of you out there who are physicians or scientists, I encourage you to browse its back issues on its website to see what kind of articles this journal publishes. For example, in the very same issue as the Geiers' paper, there are three articles casting doubt on the concept of the "shaken baby syndrome." (Blaming "shaken baby syndrome" on a vaccine reaction is how baby killer Alan Yurko got off, and he was aided and abetted by Dr. Mohammed Al-Bayati, he of the HIV/AIDS denialist fame.) Indeed, there seem to be many such articles scattered among the issues available on the JAPS website. There's also a "case study" of treating Herpes Zoster with vitamin C. In other issues, JAPS has published articles supporting a link between abortion and breast cancer; an article on the "medical dangers of homosexuality" (which also claimed that homosexuals who tried to change to heterosexuality "often succeed in doing so"); and an antifluoridation article; an anti-illegal immigrant screed referring to their "stealthy assault on medicine," blaming them for bringing disease to the U.S., and demanding that we close our borders; and an article decrying evidence-based medicine.
The journal is a rag. Given the low scientific quality of the articles it publishes, it's hard for me to conclude anything other than that its claim of "peer review" is a sham. Indeed, I recently became aware that JAPS is, as Terry Kopel described it:
The Journal of American Physicians and Surgeons seems to be little more than a conservative publication gussied up with a medical spin. A look at the references in the illegal-alien report, written by Madeleine Pelner Cosman--a "medical lawyer" whose previous claim to fame appears to be a book on medieval cooking but who has also written an article for a group called Jews For The Preservation of Firearms Ownership--is chock full of hardline conservative cites, including books by Michelle Malkin and former WND writer (and Slantie winner) Jon Dougherty and articles by Phyllis Schlafly and Tom DeWeese.
Indeed, JAPS is so dubious that it isn't even indexed in the Medline database. Even the speculative and often dubious vanity journal Medical Hypotheses is so indexed. (How it managed that, I still can't figure out.) Just from perusing its back issues, one should be able to see that the group that publishes JAPS, the Association of American Physicians and Surgeons has an agenda, and that that agenda is anti-homosexual, anti-abortion, and against mandatory vaccination.
No wonder Vox Day is so quick to cite a study from this journal so uncritically.
The bottom line is that this study by the Geiers does not show what it claims to show because (1) it uses reporting databases for purposes for which they were not designed and for which the agencies maintaining them don't recommend; (2) one of these databases consists mainly of unverified reports of adverse events or diseases that the parent or doctor attribute to vaccines, whether correctly or incorrectly; (3) the authors use such mind-bogglingly simplistic statistical techniques to analyze the data that no conclusion can be made, certainly not the one they claim to make; (4) the investigators, Mark and David Geier, have a track record of abusing science and medicine, even to the point of proposing chemical castration as a treatment for autism in order to "increase the efficacy of chelation therapy"; and (5) the journal in which the findings are published is run by an organization that is expressly antivaccination. Could mercury from thimerosal in vaccines be a major cause of autism? I suppose it's possible, but certainly this study doesn't support such a link. Nor do any of the studies by the Geiers, most of which are published in JAPS and other not-so-reputable journals.
Given the fast pace of developments on mercury/autism front, as I was writing this I had to wonder what was happening to produce so much bullshit at such a rapid rate over the last couple of weeks. Then I noticed something. David Kirby's Evidence of Harm, the book published about a year ago that fanned the flames of this trumped up controversy, ultimately leading to Robert F. Kennedy, Jr.'s mendacious Salon.com article in June, has just come out in paperback. Could all this new activity by the Geiers and RFK, Jr. have anything to do with this?
Nahhh. Couldn't be.
Hopefully, I won't have to blog on this topic again for a while. I feel dirty after having had to dive into the bowels of the Geiers' bad science and quack treatments for autism and RFK, Jr.'s distortions and logical fallacies so many times in a mere week and a half. Given so much bad science, I fear the impact on my science and critical thinking skills if I have to read any more of the Geiers' papers without at least a rest to let my brain recover. (Even worse, writing this rebuttal distracted me from the Oscars.)
Time for a shower.
Some previous posts on this topic:
NOTE: Due to a serious spam attack on this article, trackbacks and comments have been turned off.
Comments
You claim lawyers have inflated the numbers in the database. That should make it more difficult for the Geier's to show a decrease. So, using your logic, there must be more of a reduction than they were able to show.
You call the statistics simplistic. We're not dealing with the Daily Racing Form. It's just kids who are autistic and kids who are not, nothing complicated about it.
Arguments ad hominem to knock the Geier's and the publication indicate you are just clutching at straws.
There was more evidence of improved children posted on EOHarm yesterday. That evidence just keeps increasing. Have you picked out a new pseudonym to hide behind when you have to eat your words?
Posted by: Fore Sam | March 6, 2006 7:53 AM
Interesting how you picked up on a minor and speculative part of my overall argument that could be discarded without affecting its validity (the speculation about lawyers and lawsuits) and then misrepresented it, rather than addressing the meat of my arguments: the incorrect use of these two databases and the simplistic and incorrect statistical analysis.
No surprise there.
Posted by: Orac | March 6, 2006 7:56 AM
Orac;
Just as I was not surprised when you admitted chelation was the proper treatment for mercury poisoning but maintained it isn't indicated in autism in spite of the fact that kids are improving with it.
Autistic or not autistic does not require complicated statistical analysis. Simple does not equate to simplistic.
Posted by: Fore Sam | March 6, 2006 8:14 AM
Hi Orac,
Beautiful takedown. No stone unturned.
I remember the first time I ever submitted a research article as a first-author. I was terrified. What if I did something wrong? What if I was missing something obvious? What if someone came along and used a different technique and completely invalidated what I did? In the end I had to simply accept that someday someone might poke holes in the work, but not today.
Why don't the Geiers, and people like them, worry about this?
There is no way that any respectable scientist read their manuscript and encouraged them to publish it. And the sad news is that the hopes of parents are being pinned to this garbage because they're being told that it's peer-reviewed, so it's fact.
"Autistic or not autistic does not require complicated statistical analysis. Simple does not equate to simplistic."
Then what you're saying is that the Geiers shouldn't have put this garbage into press?
Posted by: Bartholomew Cubbins | March 6, 2006 9:44 AM
I fully understand that dumpster diving is not your goal in life, but, you do it so well! :)
I spent a good portion of last night reading up on the Geiers. They are very scary people, as they have the aura of credibility about them. They are amongst charlatans-turned-expert witnesses.
These critters have a pattern. They take their degrees and then set up either a corporations (e.g. Boyd Haley) or a not-for-profit (e.g. Peter Breggin) to lend an aura of validty to themselves. The damage that they do is immeasurable.
What has to be done is to set up a national database where defense attorneys can find information on them, and use that information in a suppression hearing to have their evidence and testimony not admitted. Often, that is all the plaintiffs have going for them. After a while, these cases will form a comprehensive body of evidence which can be used over and over.
Posted by: TheProbe | March 6, 2006 9:56 AM
I'm a statistics-trained person, and I can't even begin to describe how disgusted I am at the supposed analysis in this paper.
It doesn't take a lot of work to debunk this on mathematical/statistical grounds. While I
Cubbins video is OK, it misses the key point about what's wrong with the analysis. It isn't just that you can massage data to create the kinds of regression lines that you want. This is true, but for someone who isn't mathematically trained, watching that video doesn't provide enough information. His sample set _does_ have a key point where the data direction changes - the trend in the sample data _does_ reverse, and looking at that, on the basis of what he says in his video, you could make the argument that the two line solution is a more accurate representation of the data that the single line - he doesn't make clear *why* splitting the data like that is wrong.
Here's the key, fundamental issue: when you're doing statistical analysis, you don't get to look and the data and choose a split point. What the Geiers did is to look at the data, and find the best point for splitting the dataset to create the result they wanted. There is no justification for choosing that point except that it's the point tat produces the result that they, a priori, decided they wanted to produce.
Time trend analysis is extremely tricky to do - but the most important thing in getting it right is doing it in a way that eliminates the ability of the analysis to be biased in the direction of a particular a priori conclusion. (In general, you do that not to screen out cheaters, but to ensure that whatever correlation you're demonstrating is real, not just an accidental correlation created by the human ability to notice patterns. It's very easy for a human being to see patterns, even where there aren't
any.)
Redo the Geiers analysis using any decent time-trend analysis technique - even a trivial one like doing multiple overlapping three-year regressions (i.e., plot the data from '92 to '95, '93 to '96, '94 to '97, etc) and you'll find that that nice clean break point in the data doesn't really exist - you'll get a series of trend lines with different slopes, without any clear break in slope or correlation.
So - to sum up the problem in one brief sentence: in statistical time analysis, you do not get to pick break points in the time sequence by looking at the data and choosing the break point that is most favorable to your desired conclusion.
-MarkCC
Posted by: MarkCC | March 6, 2006 9:56 AM
Fore sam:
Sorry, but you're wrong about that.
If you're looking at a database containing un-reviewed reports, and the claim is that people are adding reports in order to bolster a lawsuit, then what you would expect is for the pattern of reports to match a time-trend predicted by any changes related to the causal relationship charged in the lawsuits.
If you're talking about something like this autism debate, where the lawyers are claiming that mercury in thimerasol is the cause of autism, then you'd expect to see a trend of increasing claims up to the point where thimerasol was removed from the vaccines, followed by an immediate reversal.
That is, *exactly* the trend that the Geiers claim to have discovered.
If you were seeing a *real* change in the data, then you would expect to see a *slowing* of the increase trend as thimerasol-containing vaccines were gradually replaced with non-thimerasol versions, leading to a descrease leading towards a decrease. You would *not* expect a sharp inflection point, but a gradual shift.
*And*, given that autism generally isn't diagnosed immediately, but after several years, you would expect that the trend line wouldn't shift instantly at the point of the vaccine switchover, but with a lag of several years.
An immediate inflection just doesn't make sense. But since the immediate inflection is
a *created* phenomenon, by cherry picking the data, it doesn't matter - there isn't a real inflection point, which you can see by analyzing the data yourself using a valid time-trend technique.
Is there a thimerasol relationship to autism? I'll be honest - I don't know. I'm very skeptical, but I don't know. But this purported relationship shown by the Geiers is just shoddy math - it's using human bias to select datasets that reflect a pre-selected
conclusion, without regard for whether the data actually really matches the conclusion that they want. This conclusion does not match what you would really predict for an thimerasol-autism relationship.
-MarkCC
Posted by: MarkCC | March 6, 2006 10:08 AM
"It's just kids who are autistic and kids who are not, nothing complicated about it."
It is simply astounding that Fore Sam can find the button for posting comments.
Posted by: DJ | March 6, 2006 10:20 AM
Fore Sam said: Just as I was not surprised when you admitted chelation was the proper treatment for mercury poisoning but maintained it isn't indicated in autism in spite of the fact that kids are improving with it.
Chelation can be the appropriate treatment in cases of real heavy metal toxicity such as lead poisoning, it can help to remove some of the heavy metal but it can not repair damage caused by heavy metal poisoning and does nothing to increase IQ for victims of real heavy metal poisoning. Since autism is not heavy metal poisoning, and there is very little evidence to suggest that it is, chelation is not an appropriate treatment for autism. Your favorite 'chelation agent', alpha-lipoic acid, does not effectively bind and 'chelate' mercury allowing it to be excreted as an ALA-Hg compound. In fact there are a few studies to suggest that it enhances Hg toxicity and increases intracellular Hg levels.
Simple does not equate to simplistic.
Sometimes it does.
Posted by: Not Mercury | March 6, 2006 10:21 AM
It would be interesting to see how many parents who are chelating their autistic kids have a)heavy metals toxicity lab results from a) real labs, ie: not DDI, et al. and b)those toxicity results were obtained with out chelator provocation and interepreted by a board-certified toxicologist.
Posted by: Dad Of Cameron | March 6, 2006 10:44 AM
Mark CC;
You brought up the lawyers but you forgot to consider the statute of limitations and the affect that mey have on the numbers. You also don't know how many people did not report to VAERS that should have. Frankly, I don't see how anyone can claim a valid result from looking at VAERS.
To me, the only numbers that are useful are the fact that 76% of people reporting to the Autism Research Institute observed improvement with chelation. You also have the fact that thimerosal containing vaccines are still on shelves with expiration dates of 2008 and the flu shot and tetanus shot still have mercury which muddies the waters in trying to analyze any of this. You won't have your answers until all the mercury has been out of vaccines for 6 years and you can get accurate numbers from the schools. Our politicians have been bribed to prevent that from happening.
Posted by: Fore Sam | March 6, 2006 11:01 AM
Here's a nice, comprehensive few paragraphs on the limitations of VAERS data from a discussion of the Geiers' article, "Neurodevelopmental disorders after thimerosal-containing vaccines" in Parker et al., Thimerosal-Containing Vaccines and Autistic Spectrum Disorder: A Critical Review of Published Original Data (Pediatrics Vol. 114 No. 3 September 2004, pp. 793-804):
"We identified multiple methodologic concerns regarding this article. The key outcome measure, calculation and comparison of AE (adverse event) incidence for thimerosal-exposed and unexposed infants, requires accurate and unbiased assessment of the numerator (children with defined AEs) and denominator (exposure/no exposure to thimerosal-containing DTaP) for the 2 groups. Several factors contribute to substantial inaccuracy in the numerator of AEs. VAERS is a passive reporting system that is monitored by the Centers for Disease Control and Prevention (CDC) and the FDA and to which anyone—health care provider, vaccinee, or parent—may report an AE after vaccination. Although the authors postulated complete reporting of AEs by stating that "all adverse reactions are to be reported to the VAERS database as required by US law," in fact, reporting is mandated only for events included in the "injury table" of the National Vaccine Injury Compensation Program; ASDs and NDDs potentially associated with diphtheria, tetanus, whole-cell pertussis (DTP)/DTaP or thimerosal exposure are not mandated. Moreover, for these and other adverse reactions, substantial underreporting occurs. Underreporting is particularly common for events that are not in the compensation program, for events that are not defined by a specific diagnostic test, or when the temporal relationship with vaccination is not well defined, both of which apply to the conditions evaluated in this study. In addition, events in VAERS are classified on the basis of a reported diagnosis or a coder's interpretation of symptoms/signs included in a comment field. Diagnoses are not validated. The authors do not report which diagnosis or symptom terms they abstracted from the VAERS database or how they dealt with diagnostic overlap or incomplete records. This is particularly troubling because the disorders reported have a long differential diagnosis and because the mean age reported for children with autism (1.7 ± 1.1 year) is below the age at which a reliable diagnosis of that disorder is made. Demonstrating the statistical fragility of analysis of this database, if only 1 child who has autism and did not receive thimerosal-containing DTaP were misclassified into the thimerosal group or if 1 such child were not reported to the VAERS system, then the reported risk ratio would be reduced by half and the P value would be >.05."
"In addition, several biases may have led to differential reporting of events in children who received DTaP vaccines that did or did not contain thimerosal as a preservative affecting the ability to compare relative reporting rates. In a setting of incomplete reporting, if parents or providers, either of whom can report to VAERS, are aware of a possible link between thimerosal exposure and NDDs, then reporting by either group may be greater among those who have been exposed ("reporting bias"). This bias also may have affected description of symptoms and had an impact on how events were coded. "Diagnostic bias," with providers more likely to diagnose autism or other NDDs among children who were exposed to thimerosal, also may have occurred. Because of FDA concern and subsequent recommendations by the American Academy of Pediatrics and the US Public Health Service for precautionary thimerosal removal in July 1999, with associated media interest, there was a substantial risk that these biases occurred in a study that includes AEs reported through 2000. VAERS data show markedly increased reporting of autism during the second half of 1999 and 2000, consistent with reporting bias."
"An additional problem affecting numerator data is the inability to define accurately total thimerosal exposure in children with reported AEs. VAERS reports include only the vaccine type and manufacturers for the visit associated with the AE and within 4 weeks before that date. It is not possible to define whether a child received thimerosal-containing or -free DTaP vaccine at previous visits or other vaccines that may or may not have included this preservative. As NDD risk was hypothesized by the authors to be related to the total thimerosal exposure rather than only thimerosal in DTaP, the inability to define that exposure represents a significant limitation."
Posted by: Kathleen Seidel | March 6, 2006 11:02 AM
" he doesn't make clear *why* splitting the data like that is wrong. "
Thanks MarkCC - he's right, I struggle with scientific depth versus time/file size and I tend not to use a hammer to drive home points.
I appreciate the depth and intensity that this pathetic attempt at swaying public opinion, otherwise known as the Geier family paper, is being analyzed and publicized. I'm convinced that people will benefit by this commentary.
Posted by: Bartholomew Cubbins | March 6, 2006 11:24 AM
I wonder if Kathleen's autistic child was reported to the VAERS database. How many others were not reported before anyone knew they had a case against the vaccine manufacturers? I say the decrease is much more marked than can be gleaned from VAERS.
Posted by: Fore sam | March 6, 2006 11:55 AM
Any "medical" or "scientific" paper which has a book of the Old Testament listed as a serious reference (i.e., the Lerman paper) has lost what little credibility it may have started with in my eyes.
Posted by: Liz Tracey | March 6, 2006 12:14 PM
VAERS: Custom-made by lawyers who believe autism is caused by thimerosal to prove that autism is caused by thimerosal.
Posted by: BronzeDog | March 6, 2006 12:30 PM
Perhaps if you directed some of your "skepticism" at the pharmaceutical industry, you wouldn't be so wound up about these insignificant people. Conflict of interest, much?
Posted by: Govinda | March 6, 2006 12:35 PM
Great article Orac. This piece (along with MarkCC’s excellent comments) should be the reference rebuttal to the ridiculous Geiers’ paper that no doubt we will be hearing about again and again in the future. Consider it bookmarked.
And what about that “Evidence-Based Guidelines: Not Recommended” JAPS paper? To quote the paper: “EBGs [Evidence Based Guidelines] are irresponsible, and should not be recommended.” Hilarious.
Fore sam:
You should know it is not ad hominem when you also refute the arguments (as Orac did) as well as question the integrity of the source.
Posted by: Skeptico | March 6, 2006 12:55 PM
I have had a look at the Journal of American Physicians and Surgeons, and -- doggies! This thing is way below trash.
In fact, reading the book reviews (try it if you have a strong constitution) I got a very strong sense of deja vu.
Where have I read tendentious, ideological crap purporting to be scientific? Ah, yes -- 21st Century Science and Technology, published by Lyndon LaRouche. On internal evidence alone, I'd say that JAPS is likely to be the house organ for the LaRouchies or someone similar. Does anyone out there know more about JAPS and its publishers?
Posted by: jre | March 6, 2006 1:08 PM
1. What does the pharma industry have to do with the complete and utter sloth of the autism-mercury advocates?
2. I apply skepticism equally, whenever I can. The whole pharma thing is just an off-topic red herring that distracts from the advocates' lack of evidence, and is often used as an excuse for that lack of evidence, as well as a tool for immunization against counter-evidence.
3. I get wound up by just about anyone who tells not-true statements about serious medical issues. Especially if they promise a magic bullet cure.
Posted by: BronzeDog | March 6, 2006 1:26 PM
Skeptico; Knocking the Geier's with his opinion of their reputation and doing the same with the magazine is ad hominem. These things do not address their argument.
Posted by: Fore Sam | March 6, 2006 1:38 PM
Bronze Dog;
The "sloth" of the autism-mercury advocates is curing children. Your pals in Pharma continue to poison babies.
You should be wound up about Orac telling us that chelation cures mercury poisoning but won't help autism in spite of evidence that it does cure autism. You can't worm your way around that fact no matter how much you try.
Posted by: Fore Sam | March 6, 2006 1:42 PM
Fore Sam says:
Sam, if that was all Orac did then you might have a point. But that is not all he did. He also explained exactly why the Geier's work is total crap. That does not make it an ad hominem. Ad hominem is not just a fancy Latin word for an 'insult'.
Posted by: Dave S. | March 6, 2006 2:14 PM
Fore sam:
Re: Skeptico; Knocking the Geier's with his opinion of their reputation and doing the same with the magazine is ad hominem. These things do not address their argument.
You must have problems with reading comprehension. A very small portion of Orac’s 2,500 word article was devoted to “Knocking the Geier's with his opinion of their reputation”. The majority of it was explaining the errors in their methodology.
Ad hominem is:
(My bold.)
It is only ad hominem if you only criticize the source and don’t address the arguments presented. If you demolish the arguments, it cannot be ad hominem – adding an additional criticism of the source cannot possibly invalidate the arguments that refute the source’s position.
Misunderstanding and misusing the ad hominem fallacy the way you just did is a common novice mistake.
Posted by: Skeptico | March 6, 2006 2:18 PM
Fore Sam says:
So you would predict that there will be a huge down-swing in new autism diagnoses over the next couple years in the U.S.?
If not, why not?
Posted by: Dave S. | March 6, 2006 2:21 PM
Skeptico says:
I would also note that you need not necessarily be critical of the "man" for it to be an ad hom. For instance, "Sue is too smart to be wrong here.", is also a type of ad hominem fallacy, except in reverse.
Posted by: Dave S. | March 6, 2006 2:27 PM
Dave S:
Wouldn’t that be argument from authority?
It has always seemed to me that argument from authority is ad hominem reversed.
Posted by: Skeptico | March 6, 2006 2:47 PM
Skeptico:
Yeah, I don't think there's a big difference between a positive ad hominem and an argument to authority.
Posted by: Dave S. | March 6, 2006 3:03 PM
Re ad hominem, I think it is a valid technique to criticise the opponent even without adressing the actual argument if your critique is concerning the credibility of the other. (I also think that the argument from authority should be renamed to argument from false authority - wasn't there a post on PT a while ago?).
In other words, it is not an ad hominem if I cast doubt on the reliability of a source, as long as I have facts and not insults. And the history of the Geiers, their vested interests are facts.
Didn't somebody say: "A statement of fact cannot be insolent"?
Of course, this carries not as much weight as dealing with the actual argument, but IMHO it is not off-limits.
Posted by: bcpmoon | March 6, 2006 3:43 PM
Could all this new activity by the Geiers and RFK, Jr. have anything to do with this?
It could have something to do with the fact that Special Master George Hastings forced the plaintiffs in the U.S. Court of Claims Omnibus Autism proceedings to name their experts. They filed their designation on February 14, 2006. Mark R. Geier, MD, is one of them, and he is going to have to pass muster as an expert qualified to testify about the causal relationship between vaccines and autism. Some published papers on the subject would help. (I guess a blog post by RFK Jr. doesn't do much, though.)
The claimants are still asking for additional time to produce their experts' reports. Some citable papers are going to have to materialize before they do this. The January 31, 2006 request for an extension of time is supported by a letter from Mark Geier, MD, citing problems with the VSD database as the reason he won't be able to complete his analysis anytime this year.
Anyway it's possible that this flurry of activity is litigation related.
Docket of the proceedings is here:
http://www.uscfc.uscourts.gov/OSM/AutismDocket.htm
Posted by: Anne | March 6, 2006 4:05 PM
What I really want to know, is where JAPS came up with the "peers" for the peer review. The Geiers are quite - err - unique.
Posted by: Catherina | March 6, 2006 4:10 PM
Dave S.;
I don't think a downswing will be as large as it should be since TCV's are still on shelves.
Posted by: Fore Sam | March 6, 2006 6:22 PM
Fore Sam,
and what excuse are you going to come up with when there are no thimerosal containing vaccines on the market anymore (like in Denmark) and the incidence of autism is still not plummeting? I wish the mercury blamers would make their minds up. First, the "very secret" Simpsonwood minutes are supposed to show that the effects of thimerosal are highly dose dependent with the most severe effects in the highest dose group, next on, the puny little dose in the flu shot that some children may or may not get are supposed to be enough to keep autism rates high?! Has anyone looked into how many doses of thimerosal containing flu vaccine have been given to under 3 year olds in the last 5 years?
Posted by: Catherina | March 6, 2006 6:45 PM
Catherina;
Someone looked into flu shots in old folks and figured out that if they got the flu shot 5 years in a row it increased their chances for Alzheimer's. I don't think they've been given to kids long enough to do a similar study.
Posted by: Fore sam | March 6, 2006 7:23 PM
fore sam:
that "someone" was Fudenberg and that statement belongs in the same dumpster the Geiers have been digging in...
Posted by: Catherina | March 6, 2006 7:38 PM
Wrong, John. That is a myth that has been propagated by antivaxers after Hugh Fudenberg made that claim in a talk he gave in 1997. There is not a single scientific study that supports it. In fact, there is preliminary evidence that vaccines can protect against Alzheimers. I've already written about the origin of that myth.
Posted by: Orac | March 6, 2006 7:41 PM
Fore Sam said:Someone looked into flu shots in old folks and figured out that if they got the flu shot 5 years in a row it increased their chances for Alzheimer's.
I guess you know that you'll be expected to produce a reference for that ridiculous statement. Could the 'someone' possibly be your hero Boyd Haley?
Posted by: Not Mercury | March 6, 2006 7:43 PM
The "sloth" of the autism-mercury advocates is curing children. Your pals in Pharma continue to poison babies.
Repeating an untrue statement doesn't make it true: Your sloth is refusing to do more than parrot that quack line over and over. Try showing me the data and you'll win me over. You know what it takes, but you still refuse to do that very simple act.
And stop using the depraved "Obtain disapproval" propaganda technique. I have no ties with Pharma, just like I have no ties with the MiB, the illuminati, Israel, Palistine, the Communist Party, or Al Queda. Guilt by imaginary association was a beloved tactic in the Red Scare.
You should be wound up about Orac telling us that chelation cures mercury poisoning but won't help autism in spite of evidence that it does cure autism. You can't worm your way around that fact no matter how much you try.
What evidence? That unverifiable, uncontrolled, unblinded just-so story you've drawn unsupported conclusions from that you refuse to answer fundamental questions about?
Posted by: BronzeDog | March 6, 2006 8:51 PM
As someone who believes there is a vaccine/autism link, I think it's great to have people engage in these discussions even if they are finding fault with studies that attempt to prove a link. But I have always found it frustrating that these critiques are so one-sided. Orac and friends, why do you assume that the studies produced by the CDC are correct? If you're going to stand up and declare that there is no link between vaccines and autism, don't you have to investigate the claims of the CDC with the same vigor that you investigate the work of the Geier's? Have you ever reviewed the CDC study that was published in Pediatrics? Below is an excerpt from Sander Greenland, Professor of Epidemiology at UCLA, who
submitted expert testimony to the Vaccine court on January 31, 2006. The full report can be found here:
http://www.uscfc.uscourts.gov/OSM/AutismDocket.htm
His concerns with the CDC study follow:
Whether justified or not, deep suspicions have arisen regarding the published CDC report (Verstraeten, 2003) from the VSD database, due to a series of events that preceded publication (among them, changes in data,
methods and results that occurred between the initial unpublished analysis from early 2000 and the 2003 publication, including exclusion of data from a
large HMO; move of the lead author to Glaxo Smith Klein; and refusals to provide access to the data). Further analyses of the data by independent parties would address concerns that the published results had been manipulated to conceal thimerosal effects.
Regardless of their origin, the published VSD study did have many questionable aspects of analysis that may have obscured effects, if any effects were present. Most of these problems were pointed out by Dr. Harland
Austin at the Omnibus Hearing in September 2004, and I can corroborate his testimony. Of great concern to me is the failure to pool results across the HMOs. As Dr. Austin stated, pooling is standard practice, and should be
done using sound techniques. Instead, the published VSD study used a very small HMO C (Pilgrim) to "validate" findings from the much larger HMO B (Kaiser) and A (Puget Sound), which as Dr. Austin noted, is not good practice
because it has extremely low power (is very likely to miss effects, compared to correct pooling methods). The published results from HMOs A and B also employed questionable restrictions on the comparison children, to
clinic or emergency-room attendees, which further reduces power. The authors of the published study also excluded comparisons when the case total was less than 50, on the grounds of "power considerations." This is a fallacious
reason for exclusion, because all power considerations after data are collected can be addressed by examining the confidence intervals for the comparison; the latter show what effect sizes cannot be reasonably excluded, based on
the analysis.
In addition to having serious analytic problems as just enumerated, the published VSD study did not employ births beyond 1998, and did not fully justify exclusion of data from all the other VSD HMOs. The use of births in
subsequent years would further enhance the power to detect effects, if any are present, as would use of data from other VSD HMOs as appropriate.
Thus, a new analysis of the VSD database addressing the analytic problems of the published analysis, and incorporating as much data from subsequent years and
other HMOs as feasible and justifiable, would both allay concerns about impropriety of the 2003 publication, and provide considerable additional scientific information.
Posted by: killerjabs | March 6, 2006 9:21 PM
Not Mercury;
My hero is Bobby Orr (bow) but, for this, Haley will do.
Posted by: Fore Sam | March 6, 2006 9:51 PM
Bronze Dog;
Just because we parents don't bother conducting scientific studies while we cure our kids doesn't mean what we have to say is false. You and your pals here wouldn't dare contact all of us to do those studies because you're afraid of what you'll find. Then Orac would have to eat his words about chelation not curing autism even though he says it cures mercury poisoning. It's nice to know, however, that he agrees with Andy Cutler on that.
Posted by: Fore Sam | March 6, 2006 9:57 PM
Fore Sam:
Just because you parents believe you are curing your kids doesn't mean what you have to say is true. You and your pals don’t dare to look at the studies because you're afraid of what you'll find. Then you would have to eat your words about chelation curing autism.
Hey, this is much easier than having to provide evidence.
Posted by: Skeptico | March 6, 2006 10:04 PM
Just because we parents don't bother conducting scientific studies while we cure our kids doesn't mean what we have to say is false.
True, but it does mean that you're not gathering good evidence.
You and your pals here wouldn't dare contact all of us to do those studies because you're afraid of what you'll find.
So, then, why do I keep asking direct links to those studies? And why do you not provide them?
Then Orac would have to eat his words about chelation not curing autism even though he says it cures mercury poisoning.
Hey, I've had to risk eating my words before. And if thimerosal causes autism, I'd want to know right away. But you won't give me any evidence, despite months of requests. You're even tight-lipped about your "Ace of Trumps" anecdote, and why I should accept it over replicable studies designed to filter out bias and alternative explanations.
It's nice to know, however, that he agrees with Andy Cutler on that.
Don't know who that is, don't particularly care, but I smell more guilt by association.
Posted by: BronzeDog | March 6, 2006 10:14 PM
Skeptico;
Nice to see you have a sense of humor.
Studies paid for by people who want to disprove the connection don't bother me since my kid keeps improving inspite of that "junk science". The day will come when I'll be out golfing with my formerly autistic son and you guys will still be trying to tell people chelation won't work. The problem with that is that, after we get enough of our kids cured, we'll probably be able to file malpractice suits against doctors who keep giving patients this bad information.
Posted by: Fore Sam | March 6, 2006 10:16 PM
Dumpster Diving Duo and Sham Peer Review
Heh heh
Can it get any worse for the vaccine litigants?
Posted by: Nana | March 6, 2006 11:25 PM
Oh, come on, Best.
Don't you know autistic people improve without any biomedical intervention?
Really. It's a delay, not a freeze.
Posted by: Michael "Sotek" Ralston![[TypeKey Profile Page]](http://scienceblogs.com/insolence/nav-commenters.gif)
|
March 7, 2006 12:51 AM
It puzzles me that the incidence of autism is so gender biased. How come boys are getting so many more vaccinations than girls?
[/sarcasm]
Posted by: Graculus | March 7, 2006 1:08 AM
Orac, a biostatistician did take a look at the data. He (sort of) reaches similar conclusions.
Well, well. Here's to keeping an open mind and following the data wherever it leads. I don't have a "dog in the fight", as Wade Rankin would say, so it really doesn't effect me personally if autism = mercury or not. (Though I would be forced to eat a considerable amount of crow myself.)
<sarcasm>
Fore Sam: For the love of Gaia, please stop the broken record routine of trying to force these scientists, doctors, mathematicians, etc. to accept that in the past few years, a few hundred autistic kids seem to have had their symptoms abate, partially or totally, due to chelation. You are just a dumb, irrational, and delusional parent thowing your money away on chelation and golf. Shut up already!
</sarcasm>
PS2
Posted by: Patrick Sullivan Jr. | March 7, 2006 3:31 AM
1. Natural improvement. Your silence on your observation controls suggests that you've done nothing to eliminate that explanation.
2. Proper testing protocols reduce or eliminate bias in studies. A blinded liar doesn't know which results to manipulate. With independant replication, it gets harder and harder each time. Oh, and appeal to motivation. If you have a problem with the studies, debate their contents, not the motives that exist in your unfalsifiable Illuminati conspiracy hypothesis.
Well, what do you expect? We can't change our minds if you and your ilk
1) Don't bother trying to understand or even acknowledge our objections to your shoddy "evidence".
2) Continue to rely on insinuation and innuendo and other forms of political trickery, rather than scientific data to convince us. (Is this a good time to mention that I think propaganda tactics are a form of barbarism?)
3) Implicitly minimize scientific data gathering as some ivory tower concept, even though it's not much different than what intelligent children do in "puzzle dungeons" in the Legend of Zelda series instead of flipping random switches until they get the result they want. If you want to bring in blinding, think Pepsi Challenge.
Posted by: BronzeDog | March 7, 2006 7:31 AM
Hey Pat;
I'll shut up when the scientists stop lying.
Bronze Dog;
Have you ever met any of our kids?
Posted by: Fore Sam | March 7, 2006 8:44 AM