First, it was anti-vaccine "martyr" Andrew Wakefield's infamous 1998 Lancet paper.
Then it was his equally incompetent 2009 NeuroToxicology paper.
Now it's Wakefield's 2000 American Journal of Gastroenterology paper:
Errata, Corrigenda and Retractions
Am J Gastroenterol 2010; 105:1214; doi:10.1038/ajg.2010.149
Retraction: Enterocolitis in Children With Developmental Disorders
A J Wakefield, A Anthony, S H Murch, M Thomson, S M Montgomery, S Davies, J J O'Leary, M Berelowitz and J A Walker-Smith
Am J Gastroenterol 2000; 95:2285-2295
On 28 January 2010, the UK General Medical Council's Fitness to Practice Panel raised concerns about a paper published in the Lancet by Dr Wakefield et al. (1). The main issues were that the patient sample collected was likely to be biased and that the statement in the paper, that the study had local ethics committee approval, was false. There was also the possibility of a serious conflict of interest in the interpretation of the data. The Lancet has now retracted this paper (1). This paper in the American Journal of Gastroenterology (AJG) (2) also includes the 12 patients in the original Lancet article and therefore we retract this AJG paper from the public record.
I wonder how many more Wakefield papers are destined for retraction. Certainly, any paper that used data from the children in his original Lancet paper for which he was found to have committed unethical conduct is a reasonable candidate to share the fate of the three papers above. It's only too bad that all his incompetent science can't meet the same fate. It will have to stand as an object lesson that crap remains in the scientific literature. In the meantime, Wakefield is devolving further and further into Mike Adams territory.
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Maybe the publisher will retract his novel.
It may be destined for the bargain bin in a couple of months.
I am thinking that I will be able to pick it up for about $1 at the Super Bargain niche in my local Half Price Books in about six to eight months.
He is responsible for the crippling of thousands and the deaths of hundreds of children. In a just world he'd have a new position as "Strange Fruit" hanging from the nearest tree.
a.nuran: "He is responsible for the crippling of thousands and the deaths of hundreds of children. In a just world he'd have a new position as "Strange Fruit" hanging from the nearest tree."
Crippling? Deaths? Really? Certainly you have proof of this and this wouldn't be you fantasy.
Methinks a lot of the bloggers just jump in and kick like street thugs kicking a man on the ground when others are already doing it.
Mr. Creosote is right. It should be unethical.
Please keep us updated regarding this issue.
Now there's a bit of good news.
Seeing Wakefield hoist on his own petard.
I don't know. The IUMS&D* has strict rules about ethical conduct. Paying children for samples is definitely too ethical for them.
* International Union of Mad Scientists and Doctors
A while ago I compiled a list of his papers using PubMed. I should check if it's still on the hard drive.
If they're going to start cleaning out his older papers, they should start with his Crohns' papers, which in hindsight should have given him away as a fraud years before the autism vaccine scare.
And, while we're at it, why not see if we can do something about his medical degree?
Off topic: -Hello Orac et al. You have experience detecting BS, so I am forwarding some links from Sweden in case you or some of your colleagues are interested in this subject. If it works, it would certainly have big public health consequences.
Is this for real, or a vastly overoptimistic weight-loss approach?
Charlotte Erlanson-Albertsson, a professor at the university of Lund, Sweden [which should count for credibility], has spent a long time researching metabolism and the physiological chemistry of obesity. The last few years she has been doing research on the effect of chemicals in thylakoids âcomponents of plant organelles- in delaying fat digestion and suppressing appetite. (She has even set up a company, Thylabisco, with the purpose of selling concentrated amounts of these chemicals for weight loss purposes, but this does not necessarily detract from her claims, since even legit researchers do the same)...
I should mention that so far there are only (to my knowledge) successful results using lab mice. They may have progressed to testing the effect on people since I last heard anything.
Here is Erlanson-Albertssonâs web site: http://www.erlanson-albertsson.se
Articles: http://www.erlanson-albertsson.se/publikationer.html
Example of articles: -Thylakoids promote release of the satiety hormone cholecystokinin while reducing insulin in healthy humans http://www.erlanson-albertsson.se/humansthyl09.pdf
-Appetite suppression through delayed fat digestion http://www.erlanson-albertsson.se/ny_dimaele06.pdf
-Chloroplast membranes retard fat digestion and induce satiety -Effect of biological membranes on pancreatic lipase-colipase http://www.erlanson-albertsson.se/ny_thyl06.pdf
(Swedish-language summary from an article) http://sverigesradio.se/sida/artikel.aspx?programid=83&artikel=2874498
Good luck sorting the wheat from the chaff. Birger Johansson
Umeå, Sweden
Can you imagine the screaming that would ensue if a pharmaceutical company ran a clinical trial without EC/IRB approval, and then lied about it?
Disclaimer: I work for a pharma company, no involvement in vaccines. Also as a disclaimer, I've always obtained regulatory and ethics committee approval for every study I've run.
OFF TOPIC:
http://news.yahoo.com/s/nm/20100602/sc_nm/us_costarica_stemcells
Costa Rica has ordered the country's largest stem cell clinic to stop offering treatment, saying there is no proof that it is effective, the country's health minister said on Wednesday.
About 400 patients, mostly foreigners from the United States, have been treated at the Institute of Cellular Medicine in San Jose for multiple sclerosis, arthritis, spinal injuries and other illnesses.
"This isn't allowed in any serious country in the world," Health Minister Maria Luisa Avila said in a telephone interview.
The Health Ministry several weeks ago ordered the clinic, owned by Arizona entrepreneur Neil Riordan, to stop performing the treatment, in which stem cells extracted from the patients are reinjected into their bodies.
Also off topic:
The Mexican Supreme Court has allowed a conviction to stand in the case of two herbalists and "natural healers" who swindled money out of people by promising cures for all sorts of ailments. In their decision, the Court also allowed for the prosecution of such "charlatans" when their remedies have no effect where one was offered or when they discourage people from seeking conventional care.
(In Spanish: http://www.milenio.com/node/457562 )
It must be the international day on "Insolence".
@Tsu Dho Nimh
Hmm...an Arizona man owns a clinic in Costa Rica, offering dubious treatment. He wouldn't be trying to swindle people out of some money by locating his clinic where the FDA's regulations don't apply, now, would he? I mean, if his treatment worked, why not do the clinical trials and get it approved in the U.S.?
@Birger Johansson
You might be better off with one of these places
http://www.badscience.net/forum/
http://forums.randi.org/
Plenty of sceptics with more time than orac to look into the viability of dubious claims.
"He wouldn't be trying to swindle people out of some money by locating his clinic where the FDA's regulations don't apply, now, would he? I mean, if his treatment worked, why not do the clinical trials and get it approved in the U.S.?"
Well because Big pHarma would just silence him (or worse!) of course! /sarcasm
I wonder if this one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1187154/?tool=pubmed may be next. The results are demonstrably false, at the very least.
@ Little Augie
Are we really going to play another game of "Let's move the goalpost!" again?
chance: "Are we really going to play another game of "Let's move the goalpost!" again?"
Force mass vaccinators can move them with the best of them. All one has to do is watch these threads and watch the science fade away as it ultimately turns political.
"Oh no, Brer rabbit don't throw me in the briar patch."
@16, Little Augie.
Really? Politics have nothing to do with public health? The very basis of our social contact is that we often sacrifice personal liberties to protect the health and safety of others - vaccination are among thoses. And as I recall, except in cases of federal court orders in the event of an outbreak, no one can force you to get vaccinated - you still have the choice to homeschool and expose as many other children to your walking disease vector. And no one's advocating that someone strap you to a chair, and force you to take any vaccine - most simply want parents to understand that a lot of the information out there against vaccination is, franky, crap that is fueled with a poor understanding of basic sciences. It's not unrelated when the science is used to support a political position that the opposing side wants to bring us back to the early 1800s in terms of public safety from disease.
Unfortunately, the Science of Vaccination and the Politics of Vaccination will always have a hand in hand, because the other side often uses those politics with their star power and the poor education of our general society.
Well, how many are left?
chance: "Really? Politics have nothing to do with public health?"
No, the exact opposite. Thank you for confirming. Your magical scientific vaccine powers dwindle in the briar patch. And this is what FUMES the biased scientists on here.
chance: "you still have the choice to homeschool and expose as many other children to your walking disease vector."
Maybe you live in West Virginia. I don't. And I still have the choice to send them to public school.
@Dan Weber
Doing a search on PubMed for "Wakefield, Andrew J" brought up 9 results. Excluding two that are not studies and the retracted Neurotoxicology study, there are 6 remaining.
well maybe the journals etc. will clue in and retract some other "studies" (like Fombonne's -McGill University- bullshit studies on autism prevalence in Canada and Poul Thorsen's useless figures on autism and vaccines. Hopefully that happens but I wouldn't hold my breath. Pharma is too entrenched in the journal world to hold them to any decent standards. What a complete joke!
@ Jen - Really? Anti-Vaxxers are still stuck on smearing Paul Thorsen after it was proven their accusations were nothing but bunk?
And I suppose the Amish don't vaccinate and don't have autism either, right?
Well.
I guess those scorch marks on your backside must still burn eh jen? Hint for you; studies are not 'bullshit' merely because you proclaim them to be. You need to explain what renders a study 'bullshit' and you haven't even come within the same galaxy as that.
Fombonne-McGill study from 2006 looking at rates of PDD not autism per se.
OFF TOPIC
Rene, I see you aren't appending disclaimers. Is all good on the job front?
The retraction of the Am J Gastro paper was fairly predictable, given that it included 1998 Lancet paper subjects. More tricky will be the O'Leary Mol Psych (disbanded) paper, since that is published by the BMJ, which declined to investigate the affair in 2004.
Before long, however, I think all eyes will be on the Royal College of Pathologists, which awarded Wakefield a fellowship, not based on exams, but on submitted papers. Since two of those have been retracted, Wakefield has been found guilty of research dishonesty, struck off the medical register and fired by his employer, it will be interesting whether they strip him of his fellowship of their own volition, or whether they will be required to be shamed into it.
augustine @16
Seeing as the science supporting vaccination as a medical intervention and the concept of herd immunity has decades of support behind it (centuries if you go back to Jenner & cowpox vaccinations), there is no particular reason to go back to the basic science.
Indeed, your basic premise in the comment is a straw man since, to repeat, there is no large-scale movement agitating to make vaccinations compulsory for all US citizens.
@jen
Which studies of thorsen's (and of course we mean ones where he is the primary researcher here) do you have a problem with and why? Be sure to list actual problems with the research in question.
@jen
Moreover, jen, what is your background in regards to science? Unless you have some history in the field, I have my doubts about your ability to evaluate primary sources. Orac (and to a lesser extent, many of us) has spent his entire career reading, evaluating, and (I would assume) participating in these studies. This stuff isn't aimed at the layperson, and it always strikes me as a bit suspect when the folks at AoA decide to critique journal articles.
mike the snake: "Which studies of thorsen's (and of course we mean ones where he is the primary researcher here) do you have a problem with and why? Be sure to list actual problems with the research in question."
You would be better served by asking Brian Deer. He's an expert at uncovering conflicts of interest and ethical breeches in research. But if Thorsen's work involves Pharma then Deer wouldn't touch that with a ten foot pole.
@22:
"Anti-Vaxxers are still stuck on smearing Paul Thorsen after it was proven their accusations were nothing but bunk"
I stepped into trouble on this one... From what can be established, Aarhus did file a complaint against Thorsen implicating him in a real crime, but the police who received the complaint do not appear to have filed formal charges. AoA's only "contribution" in establishing these facts was to link to a then-unverified document obtained by still-unknown means, repost or link to articles containing unsubstantiated or clearly false claims, and threaten and harass me for offering a critical appraisal of the evidence at hand.
What is and always has been clear is that the accusations against Thorsen amount to a completely prosaic complaint of misappropriating funds, not the prefabricated scenario of bribes, coverups and international conspiracies.
@mikerattlesnake
We should be a bit careful about using this angle of argument. While experience/education in the field does help, it is not necessary to enable one to understand, analyze and interpret the information appropriately. For example, I feel that I have a decent grasp of how to evaluate the science, even though I have no formal education in a scientific field. The closest I come is education in regulatory affairs.
While it may raise red flags about the quality of the individual's argument/understanding of the subject, it should not be used as a means of negating or downplaying what the person has to say.
@mikerattlesnake:
(sarcasm) Now you know that isn't fair. Jen read somewhere on the internet that Thorsen was a bad man; therefore it's true. She should never have to back up her claims with evidence. (/sarcasm)
augustine,
Have you read any of Brian Deer's exposes? He's been as hard on Big Pharma as he has on Wakers.
Brian,
Wouldn't the fact that Wakefield lost his ability to practice medicine automatically preclude him from being a fellow in the Royal College of Pathologists? Maybe somebody who's better versed in this can explain, but it would seem to me that if you're not licensed to practice medicine (especially through license revocation, which is essentially what happened here) that a professional medical society should automatically remove you.
Emphasis mine. Pardon me for being Captain Obvious here, but Augie, you really are thick as a plank if you think that.
Has augie actually ever come out with an opinion of his/her own? Or has he/she just come here to comment on other people's ideas?
Oh gravy, are we going to go through this again? Remember the process...
1) Find the citations to the articles for augustine
2) Provide direct links to articles for augustine
3) Read the friggin articles for augustine
4) Explain what it all means augustine
We've been through this once. Do we have to do it again?
That's obviously just a ruse to hide his allegiance to Big Vax.
Todd--
Thanks. By mikerattlesnake's standards, I should quietly fold up my tent and go sit on the sidelines with my B.A. in history. Obviously Orac and many of you have training I don't. But I can apply the tools of a liberal education, such as critical thinking and some education in math, including logic, to what I read.
Bingo. I'm sure Augustine views himself as the John McClane of science: "Just a fly in the ointment, Hans. The monkey in the wrench".
I love good debate with people of various viewpoints, when they can construct and defend a good argument. And if Augustine comes up with an original thought that's worthy of discussion, then great. But otherwise it's probably best to step over him and let the troll debate himself.
augustine @ #31:
Yet another demonstrable lie by augustine! LOL! Wow augie you already have essentially zero credibility, but you want to just keep digging that hole deeper don't you?
Here you augie, yet more proof (as if any more was needed) that you're full of crap.
Vioxx - a killer painkiller
Brian Deer investigates an "Aids vaccine"
The Drug Trial That Went Wrong
So tell us augustine, when will you be making your public apology to Brian Deer for lying about him? Will it be before or after you apologize to everyone else you've lied about and misrepresented so far?
My earlier post is being held in moderation...., but as to this from Orange Lantern
That would be accurate for augie....if McClane wore clowns shoes, used a squirt gun, and worked for the bank-robbers.
;-)
Die Hard 5: "Die Hard With an Ignorance".
@ Orange Lantern:
LOL! But I think you mean "Lie Hard".
Brian Deer,
Don't you have anything better to do than hang on Orac's every word? Aren't there any other doctors over in the UK who are trying to help children with GI problems that you can drag through the mud? How about going after doctors who talk about the dangers of H1N1 vaccines? Go get 'em Brian... Get busy!
Deer undoubtedly has Google Alerts (or something similar) set up to email him whenever a blog post about Andrew Wakefield pops up.
@Pablo-38,
I wouldn't waste the time on it until Augie shows some interest in trying to follow the step by step instructions for themself.
@mikerattlesnake and Todd W,
As I told a commenter on another blog who had a problem with "reading comprehension", my arguments (and jen's) stand or fall on their own merits including any evidence I can present in their favor. My credentials, which do include a bit of scientific training, and my actual are name are irrelevant to that.
However, since jen's comments (IMHO) mostly fall through the black hole in the floor and her evidence to support them bears a strange resemblance to AoA/GR talking points, there is a small, but non-zero possibility that inquiring about her education, scientific or otherwise, might have some limited utility as an opening to inquire about the basis for her statements with a possible end objective of leading her to the water.
I am not sanguine about that.
(Gee, that one sentence was almost Bullwer-Lytton material!)
@ 47 squirrelelite,
Don't give up on the Bulwer-Lytton Prize, yet. Where I am, it is a dark and stormy night. ;-)
"Orac's Wackosphere",
Whoever this is, I strongly suggest a new handle. If it were under my control, I would be deleting your comment, the same way I did a jester who posted under the name "Andrew Wakefield".
And, exactly who are these "doctors who talk about the dangers of H1N1 vaccines"? The only one I can think of offhand is Len Horowitz, the paranoid dentist who claims the vaccines are designed to sterilize people.
It's not for him. It's for the legions of laypeople reading this blog who don't comment and might assume that if augie's nonsense went unchallenged, then that would mean that he was right.
So please, keep embarrassing him and his sockpuppets and friends whenever they appear. (By the way, they all seem especially agitated today, eh? And Jen's officially given up on science, just like Wakers.)
David N. Brown said:
[engaging anti-vaxer emulation mode]
But, David it's like...people...you know like "Doctors" with like.... degrees and stuff! Surely that counts, right?"
[/anti-vaxer emulation mode]
Actually I think that "Wackosphere" is just a poe that pops in from time to time.
@pablo & phoenixwoman,
I agree. That is why I occasionally address comments by some of our more persistent and argumentative misunderstanders.
I remember offering my version of pablo's list on an earlier blog, but it was a late comment to an old blog and was quickly lost in the sea.
As I recall, my thoughts were something like this:
To be taken seriously as a commenter, even if not everyone chooses to agree with everything you say, you should at least do the following.
1) State what you think/understand/perceive to be the truth. Don't just toss out questions that imply disagreement even if they don't actually say so or respond to everything with a content free short retort.
2) Explain what you base that on. You don't have to provide peer-reviewed journal articles to support everything, but you should be willing to at least go to the well of real data when questioned to see if they really support what you are saying.
3) Try to make a direct response to questions. Merely asserting that the other person doesn't understand you or is biased or you just know won't convince very many people.
4) Oddly enough, be willing to correct your own mistakes or at least clarify them when questioned. It shows you care about the accuracy of what you say, not just about whether it irritates someone into responding. And that makes you more believable, not less.
David N. Brown:
No worries. We just shorten this silly troll's 'nym to "Wacko."
Orac,
Did you see this article today? Apparently, Wakefield tried to link MMR to Crohn's disease before autism.
http://www.slate.com/id/2255259
@squirrelelite: man, are you a pretentious asshole or what!! I still wonder when other "studies" will be stricken-you know shit like Fombonne's autism prevalence data and Thorsen's mishandled, problem ridden prevalence data. Oh, but pharma AGREES with their shit so their shit will stand. What a double standard. So pathetic...
@jen
Once again, rather than simply asserting that the studies are bad, you need to provide valid reasons that illustrate how they are flawed. Give us some valid critiques rather than simply saying "They're sh*t." Also, as mikerattlesnake said, to which study or studies of Thorsen's (where he is the primary author) do you refer?
"Thorsen's mishandled, problem ridden prevalence data"
At least one of Thorsen's coauthors denies that he had any role in the collection of data.
jen continues to show that she is a blithering idiot. She just parrots the stuff she reads on AoA, and even then she does not get it right.
I will state again, Fombonne's study looked at the prevalence of PDD which may seem like nitpicking, but if you are going to dismiss a study, you should at least know what the title was.........
wow, looks like a London University has just developed a urine test for autism (something about gut bugs). Interesting. Maybe Wakefield was actually on to something eh?!
@Jen at 61,
Or not. The study relied on Wakefield's prior work for its underlying gut disturbance theory and other subpar studies that were dubious at best. The sample selection doesn't appear to have been very good. Between the three groups in the study, there were around 100 urine samples; diet differences were not accounted for. And that's just off the top of my head regarding the study. For a more in-depth look at the problems, you can look at my post on it, linked through my name.
Anatomy of an anti-vax troglodyte:
*Make lofty proclamation completely devoid of any scientific merit.
*Get roundly mocked for it and ignore requests/demands for supporting evidence.
*Come back and make another lofty proclamation to distract from the lunacy of earlier claims.
*Still feel rully, rully, important that you posted your message on a hostile interwebz board.
*Lather, rinse, repeat ad nauseum.
Seems like the test picks up the abnormal urine results soon after birth (so bang goes the vaccines-cause-autism idiocy), and also identifies the non-autistic siblings too (so what does that mean, jen?)
I would definitely like to see Orac's special friend (or one of the friend's friends) take a stab at, I daresay.
jen, why don't you take this back to your AoA circle jerk since none of you will actually read and understand the study itself: http://www.nhs.uk/news/2010/06June/Pages/Urine-test-for-autism.aspx
It is a far more accurate assessment of the pee study.
@jen-56 and -61,
You have yet to show any interest in following Pablo's step by step instructions or mine, but you did respond to my comment(s), so I will take a look at what you said.
I stated:
"my arguments (and jen's) stand or fall on their own merits including any evidence I can present in their favor"
and
"since jen's comments (IMHO) mostly fall through the black hole in the floor and her evidence to support them bears a strange resemblance to AoA/GR talking points, there is a small, but non-zero possibility ... of leading her to the water."
You replied to my suggestion with the following:
"@squirrelelite: man, are you a pretentious asshole or what!! I still wonder when other "studies" will be stricken-you know shit like Fombonne's autism prevalence data and Thorsen's mishandled, problem ridden prevalence data. Oh, but pharma AGREES with their shit so their shit will stand. What a double standard. So pathetic..."
Well, perhaps I am a "pretentious asshole". Since orac characterizes himself as a
"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."
at least that puts me in good company. Perhaps he and I have something in common besides being Wolverines at roughly the same time period.
Since commenting on a forum such as this one takes at least a small amount of bravery, I do admit that my ego is strong enough to think that something I say might interest someone else. Since commenters such as Rogue Medic, Chris and Todd W among others occasionally show some interest in my thoughts, I guess I am not totally wrong in that hope. Nevertheless, I primarily write for my own amusement and so, if I occasionally choose a word or phrase that is more complex or abstruse than necessary, it is usually because I just prefer the sound of it.
"I wonder when other 'studies' will be stricken..."
Sorry, jen,
The temporal scanner was blown out trying to plot the course of Planet X in 2012 and is still out for parts replacement, general maintenance and temporal alignment, so my 3D crystal ball visual readout device is rather foggy at the moment. But since scientists do err from time to time (although few as egregiously and unethically as Andrew Wakefield) and part of the process of science is to detect and correct such errors, I expect that other papers will eventually be withdrawn. I just don't know which ones or when. But, since even limited or misleading data can have value in guiding science to a more accurate understanding, it takes really extensive malfeasance such as tampering with or outright fabricating the data to warrant such a drastic step as withdrawing an already published paper.
You have yet to demonstrate such malfeasance in any of the cases you have chosen to mention.
"but pharma AGREES ..."
No, Jen, as I stated earlier, those studies stand or fall on their own merits regardless of who agrees or disagrees. Since one of those merits is that their results are consistent with results obtained in similar research by other researchers in other locations and other countries, those studies will continue to stand.
The standard is scientific integrity, not a wide open barn door. And, since Andrew Wakefield aimed for the barn door and didn't even hit the barn, his results have fallen.
"pathetic"
I do enjoy the Symphony Pathetique, although generally I prefer Beethoven to Tchaikovsky. Perhaps it is my German dairy farmer genes. However, your statements remind me more of the Symphony Fantastique!
squirrlelite, I always enjoy what you write. Thanks for noticing.
I, on the other hand, am experience fatigue after dealing with the same tired arguments after ten years. This why I admire anyone who has dealt with Ben's parents, jen, Little Augie and the rest. I just gave up on a Wakefield Fan Boy on the Bad Astronomer blog because he was using too much cherry picking (and I just hate going through massive wall of texts hand waving).
I just hope I can put in a little dent of doubt. I may have by pointing out that the Lancet Twelve were give two different MMR vaccines (it has to do with the one American and the change the UK did in 1992).
Chris,
Thanks for pointing out the little bit about the 2 MMR vaccines. Even with the numerous blog posts about Wakefield over the last few years, I was aware of that until you mentioned it.
As I said a big motivation for my writing is my own amusement, but I also try to explain things to others and do so in a way that may be entertaining as well. It also helps me learn about good sources of information on the internet and modernize my research skills a bit.
Thanks for accompanying me on this journey.
And for anyone who wants to see me showing off my pretentious self-importance ;), I have posted a short clip from a talk I did recently on YouTube:
http://www.youtube.com/watch?v=g9wCOH-TWZk
There is a lot more, but it requires some editing and conversion work and I have been busy resurrecting a crotchety computer this week.
Have a good weekend.
Aren't those the worst? I just love being dumped upon in debates with several screenfuls of studies. I've just started responding with "Instead of spamming me with a bunch of vaugely-related links, why don't you pick two or three of those studies that you feel make the strongest case for your position, and I'll read those first". I don't think I've ever gotten a response.
squirrelite:
I look forward to watching your video. Since we have had internet service with dial-up I have always posted the expense on Quicken as "Entertainment." This is how I stayed sane during the years on Usenet (where I actually made the mistake of taking Scudamore seriously at first, and tangled with Roger Schlafly).
Orange Lantern:
(blush) I have been known to do that. I now limit myself to the dumping of my special form of a Gish Gallop when someone dumps one or two studies that are supposed to prove beyond a doubt that their special woo is true.
Though on the Bad Astronomer debate I only used the list of papers on or before 2004 that were questioning Wakefield as an indication that Brian Deer was not the only critic. I really only used three studies that answered "no" to the question of "do autistic children have more GI issues."
@ Chris: Get this. I looked at your interchange on BA and guess what? I had a conversation with the exact same guy on HuffPo. I got suspicious because I thought had read the same text around post #59.
It was JonGH on a HuffPo article concerning the lack of an Autism/GI link, and after some back and forth, he dropped one meeellion studies (many of which had nothing to do with the topic, or actually detracted from his position) in my lap. I gave the response I mentioned above and received a sidestep in response.
Here's some of it, if the link works correctly:
http://www.huffingtonpost.com/2010/04/16/autism-bowel-disease-may_n_540…
Small blogosphere, ain't it?
Orange Lantern, looking at that was a deja-vu moment!
He is a real piece of work.
That is the standard MO - I assume they just do a search for keywords (autism + vaccination for example).
I am not sure if they
A. - Assume that the papers must support their case because they are so sure they are right.
B. - Think the papers support their case because they don't understand them.
C. - Know the papers are opposed to their argument but cite them anyway assuming no-one will check on them or be able to interpret the papers. This a bad assumption to make on science blogs.
D. - Don't care one way or the other what the papers say since they are relying on the assumptions in C.
Are they narcissistic Dunning-Kruger lackwits, clueless D-K lackwits, liars or bullshitters?
I vote for Dunning-Kruger chronic liars.
I wonder if it's occurred to jen that the colon and the urethra are not the same thing?
@ 74 Militant Agnostic,
It is probably a combination, but I expect that a lot of them believe that they know the answer, so they just assume that all of the evidence supports their belief.
This is not easy to reconcile with an understanding of the scientific method, so they are not likely to understand if there are any valid conclusions to draw from any particular study.
In other words, this should be an excellent group for in depth investigation of the Dunning-Kruger effect.
Someone was asking about the Fellowship of the Royal College of Pathologists that Brian Deer mentioned up the thread. You don't have to be a doctor / MD / pathologist to be a member or fellow - PhD types working in hospital biochemistry can and do take the exams too. So getting struck off the medical register won't necessarily bar Wakefield from the Fellowship.
As I said over at Left Brain/Right Brain when the AmJGastro retraction was discussed, I would guess Wakefield submitted a compendium of mostly his pre-Lancet paper collected work for the FRCPath. Assuming that is right, it could be argued that this isnât necessarily âtaintedâ by the ongoing cave-in of his post-1998 output. Even if one views everything post-Lancet paper as highly suspect (to say the least), given it largely came from the same patient group and their archived samples that were likely obtained unethically, that doesnât automatically bear on the earlier research. At least, not taking a strictly legalistic sort of view.
Of course, one might wonder whether all St Andy's earlier work (e.g. the stuff trying to link MMR to adult Crohn's disease) didn't conform to the same general standard of quality (or not) of lab work, and accuracy (or not) of reported clinical findings as the later stuff... but it would be hard to prove.
I can well believe the College of Pathologists would be happy to find a reason to rescind the award, though.
Finally, since we're talking about St Andy, it is not often noted that the same 1998 issue of the Lancet that published the infamous Wakefield paper also published an astute commentary on it by Chen and DeStefano of the CDC. They pointed out a bunch of the shortcomings of the study, all substantiated by later work and the revelations about things like patient selection. The commentary is amazingly prescient and deserves to be more widely known.
Put another way: it was obvious the Lancet "study" was likely a storm in a teacup (at best) - or a crock of sh*t at worst - from Day One, at least to anyone who knew where to look. Note that this did not include credulous news reporters.
I am a PhD epidemiology student who began working part-time in a preschool in a midwestern US state to offset my tuition. My teenaged son is "typically developing", so I was not aware of the high prevalence of children affected by autism spectrum disorders, ASD, and other pervasive developmental disorders, PDD, until I began working at the public school.
I observed many of these ASD/PDD children had chronic digestive and/or bathroom compliance issues too. The issue is not just "potty training", but explosive diarrhea, chronic constipation and just plain "poor pipes". I am a chemist/scientist and concerned mother, parent and teacher's aide and it was clear there was a pattern.
As I began a literature review, I was drawn to Dr. Wakefield's earliest papers, since he, and several other brave scientists had hypothesized there was an association between digestive disorder and ASD. Unfortunately, he derived his theory based on an initial hypothesis about vaccine association- whereas I saw it only as a biologic phenomena from my naive observations.
Three years later, I'm still combing the research, watching/observing children come and grow, and go in the preschool and still I am inclined to believe Dr. Wakefield's basic observations are relevant. It's unfortunate the interpretation of his work went "viral" thru a media machine and whipped up fear and frenzy over the assocation with vaccines.
There are several experimental and methodological issues with studying autism, in part due to the paradigms about how studies need to be completed in "rare disease" states. But there are also theories and constructs about how to approach ASD research which were not articulated in 1995- another "series of unfortunate events" that affected Dr. Wakefield's career. However, according to a recent interview he did on the TV show Dateline News (May 30, 2010), Dr. Wakefield appeared determined to stay true to the science and study of ASD etiology- and I respect his bravery.
There is a concerted need which affects millions of children and families, affected by diagnosis defined by pyschologists, teachers and medical professionals, but which have life-course altering impacts on all of us. Families need a champion and truth-seeker to help distinguish social defintions of ASD and biological disorders which may be a precursor to ASD diagnosis.
This blog was transferred from another chatroom on this site.
I presume people posting here have some knowledge of the original Wakefield papers written in 1995. He essentially states there tends to be illeal disfunction, unique from allergic or celiac response in ASD kids. (The plausible consequences of that relate to inability to biochemically modify heavy metals to inorganic forms which are excreted- something normal kids can do when consuming mercury in fish, subjected to thimerisol, etc.)
The "definition" of ASD has widened with the adoption of DCM-IV criteria rather than earlier Kanner criteria or DCM-III criteria which is a another variable "shifting the sands" of Wakefield's theories and interpretation of his studies.
There are several papers suggesting compromised immune and GI systems in autistic children. What is less clear is "which happened first?" The association is plausible and there is more evidence to prove that; the causation between variables is not readily proved.
The recent observational survey results reported by Schultz et al (2009) were useful in obtaining observational data about the association of ASD with acetaminophen use and the measles-mumps-rubella vaccination. Discussion by the authors reviewed the initial hypothesis that sulfation metabolism of acetaminophen may be somehow associated with autism diagnosis. Schultz et al (2008) implied autistic children may also be frequent users of anti-inflammatory drugs, which reduces sulfate production. The authors speculated reduced sulfate production may alter normal sulfation production. The authors speculated reduced sulfate production may alter normal sulfation mechanisms upon acetaminophen administration which may trigger release of neurotoxic effects or byproducts thereby causing autism (ASD). However, the authors acknowledged the potential sources of bias in identifying and surveying US parents which may affect representative quality of the study and its leverage globally.
There are concerns regarding the reliability and validity of the definition of ASD (Barbaresi et al 2009, Coo et al 2008, Croen et al 2002), which is further complicated by the fact the study subjects (infants, toddlers and pre-school children) are each experiencing highly accelerated and somewhat unique cognitive, physical and social developmental growth even among tightly defined age-cohort strata.
While longitudinal panel studies are lacking, there are several categorical or nominal definitions of autism used (Volkmar 2005) wherein childhood populations pre-defined as at-risk by parental or professional judgment. These definitions meet the construct criteria of autism spectrum disorder by Kanner, DSM-III, ICD-9 or the more generalized assessments of DSM-IV and ICD-10 (Centers for Disease Control and Prevention, Community Report from the Autism & Developmental Disabilities Monitoring [ADDM] Network, 2007).
However, even the CDC admits their sampling has not been representative, random and of adequate scale to truly monitor incidence (first expression) of autism.
References:
Barbaresi, W., Colligan, R., Weaver, A., Katusic, S. (2009). The incidence of clinically diagnosed versus research-identified autism in Olmsted county, Minnesota, 1976-1997: Results from a retrospective, population-based study. J. Autism Dev. Disord. 39(3):464-470
Centers for Disease Control and Prevention (December 18, 2009). Prevalence of autism spectrum disorders-ADDM, United States 2006. Morbidity & Mortality Weekly Report Surveillance Summaries 58(No. SS-10): 1-20.
Coo, H., Oullette-Kuntz, H., Lloyd, J.E.V., Kasmara, L, Holden J.J.A., Lewis, M.E.S. (2008). Trends in autism prevalence: Diagnostic substitution revisited.
J. Autism Dev. Disord. 38:1036-1046.
Crane, J.L. & Winsler, A. (2008). Early autism detection: Implications for pediatric practice and public policy. Journal of Disability Policy Studies 18(4):245-253
Croen, L.A., Grether, J.K, Hoogstrate, J., Selvin, S. (2002). The changing prevalence of autism in California. J. Autism Dev. Disord. 32(3):207-215.
Erickson, C.A., Stigler, K.A, Corkins, M.R., Posey, D.J, Fitzgerald, J.F, McDougle, C.J. (2005). Gastrointestinal factors in autistic disorder: A critical review. Journal of Autism and Developmental Disorders 35(6):713-726
Fombonne, E. (2003). Epidemiological surveys of autism and other pervasive developmental disorders: An update. Journal of Autism & Developmental Disorders 33(4):365-382
Schultz, S.T, Klonoff-Cohen, H.S, Wingard, D.L., Akshoomoff, N.A, Macera, C.A, & Ming, J. (2008). Acetaminophen (paracetamol) use, measles-mumps-rubella vaccination and autistic disorder: The results of a parent survey. Autism 12(3):293-307
Volkmar, F., Chawarska, K., Klin, A. (2005).Autism in infancy and early childhood. Annu. Rev. Psychol. 56:315-336
Since you are commenting on this post too, I may as well repeat my response to you here.
@ DSullivan, you are conflating issues here. The most recent works have strongly suggested that the prevalence GI pathologies in ASD children are no different than those in the general population. Additionally, those pathologies are not unique in presentation as Wakefield has tried to peddle.
http://adc.bmj.com/content/94/7/497.full
http://pediatrics.aappublications.org/cgi/content/abstract/124/2/680
Gastrointestinal findings in ASD children are mainly comprised of constipation and/or diarrhoea which are, most likely, due to neurobehaviours rather than organic.
I find it very hard to believe that a graduate epi student could have read Schultz et al (2009) and lend any credence to it. There were insurmountable biases and lack of confounding in that survey that render it, essentially useless. Acknowledging bias and doing nothing to control for it does not legitimise it.
You should know that mere observations, i.e. anecdotes cannot and do not replace proper epidemiological studies right?
What else would you expect a pathological liar to say? There is nothing brave about that man, don't mistake bravery with selfish self-preservation and massive ego.
Science Mom,
I realize the limitations and biases of Schultz's work, but only referenced it to explain there are numerous variables which at this time are not known whether they are confounding, antecedants, etc.
Please provide references and rationale for the proof that ASD and associated GI disorders are due to neurobehaviors.
Again, my interest has nothing to do with vaccines and ASD, just trying to understand basic etiology of ASD.
Thanks in advance for pointing me in a constructive direction, Todd W.
The Schultz survey was worthless the way it was conducted; it contributes nothing to the unknown aetiologies of ASDs. Any first year grad student would recognise that.
Please see my previous post, I provided 2 recent studies and please note, I didn't mention 'proof'.
DSullivan,
Using the "brave maverick doctor" card when describing Andrew Wakefield is a complete credibility fail, regardless of what kind of education you purportedly have.
Dear Science Mom,
I only see reference to the urine test/screen/indicator for ASD- which does not support a neurobehavioral theory, as far as I can tell. If you know of references, please advise. It's well documented ASD kids have different metabolic products vs. "typically developing" children- but it's unclear if that's due to their picky/selective diet or true differences in gut metabolism. Attempts have been made to provide a consistent diet among cases and matched controls, and in those studies, the metabolic differences still remained, suggesting there is a GI/biologic difference among ASD kids and their matched control/siblings.
A-non: hopefully you can ascertain opionion from scholarly evidence-based research... doesn't take a Rhodes Scholar or a rocket scientist to know the difference.
I joined this group to get scholarly input and credible, scientific insights, but can see it's not really about that.
DSullivan, Science Mom gave you two links in #81 neither of which concern urine testing as far as I can tell. The Pediatrics article discusses the neurobehavioral theory. Why don't you review them and tell us what you think.
We're all fans of science, but we can get a little emotional given the topic matter. We've had plenty of conversations with folks who feign interest in scientific discussion, but are really trolling for trouble.
And, if you are looking for only serious academic discussion with no snark, you may be in the wrong place.
Thank you Orange Lantern, I don't know how DSullivan could miss that. DS, could you please provide references so that we are on the same page?
Such opinions, however, should rely upon the best available evidence. Someone who considers Wakefield 'brave' on a science blog, will invariably be met with scepticism.
Another comment moved from an older artice
DSullivan,
I am an autistic adult with GI issues, including nonstop, low-grade abdominal pains. I have kept an open mind whether my experiences are representative of other autistics. I don't believe these issues have anything directly to do with autism. For better or worse, I've never disrupted my life with medical procedures or experimental diets to get rid of something which I can mostly just ignore. I loath the idea that problems like mine could be offered as remotely justifying Wakefield's conduct.
Science Mom,
I apologize- I now realize/read the 2 references you cited.
However, both conclude there were differences (but only looked at stool color and consistency, not metabolites); but they both generalize interpretation to suggest they're not significant. The Sandhu (2008) study acknowledges differences existed at/after 30 months of age. The Mayo Clinic looked at retrospective data records (notlikely to have collected stool data from 1967-197) and was wise conclude no difference since only 124 cases were followed for 18 yrs- talk about noise in the data!)
Regarding different metabolite excretion and ASD. Here's one reference. This is just one example of a study.
Evans, C., Dunstan, R.H., Rothkirch, T., Roberts, T.K., Reichelt, K.L. et al (2008). Altered amino acid excretion in children with autism. Nutritional Neuroscience 11(1):9-17.
I see your interpretation is rather selective. You are also shifting the goalposts as I posted those studies in response to your claim that Wakefield's had validity. The point is, is that there were no significant differences found in the groups, nor were any unique GI pathologies found, which do not support Wakefield's claim of 'autistic enterocolitis.
My library is being restamentalist right now so I can't get the full text of Evans et al. (2008) but the abstract appears supportive that neurobehaviours can alter nutritional intake. Of course that will alter metabolic profiles, as will 'therapeutic' diets and supplementation. Again, this does nothing to support Wakefield's claims.
"For better or worse, I've never disrupted my life with medical procedures or experimental diets to get rid of something which I can mostly just ignore."
Well bully for you, David. How nice that you can sit at your keyboard and tell us all about your abdominal pain that you choose to ignore. A lot of autistics don't have that luxury.
DSullivan, I hope you'll stick around. The sulfation/acetaminophen issue wrt autism interests me greatly. I'd like to see more discussion. :)
I need to refocus efforts on social epi aspects of ASD for my current term paper. Agree sulfation, proinflammatory cytokine levels, and inflammatory markers(IFN-y, TNF-alpha,and IL-5) association is very interesting. And why still are girls less likely to be diagnosed, but tend to present with more severe symptoms? Are there hormonal influences which affect onset; or are girls better as socially pretending to be "normally developing" whatever that is...
But at this point need to look at social factors; perhaps childhood attachment, theory of the mind (ie. trait versus action inference, sematic associations), and parental traits (stress, adaptability, etc.). If anyone knows of recent credible studies in that regard, please advise!