A survey administered by a German anti-vaccine homeopath backfires spectacularly

Sometimes I feel a little bit guilty when I'm writing a post deconstructing anti-vaccine nonsense, "alternative medicine" quackery, or some other form of pseudoscience. This guilt usually derives when I end up picking a target that's just too easy, a study that's just so mind-numbingly, brain-meltingly awful that it's not much of a challenge, even though at the time I perceive that it needs to be done. I suppose it's like the feeling that a professional sports team might feel if it were ever paired with a high school team--or even a junior high--team for a game. In fact, I was half-tempted just to post the link to the "study" (which it really isn't, not really) and let you, my readers, have some fun. I'd consider it an exercise in seeing just how much regular readers have learned, or even how much newer readers have picked up. At the very least, it'd be a nice new chew toy for you all.

But what fun would that be for me, other than sitting back like a proud papa and chuckling as I watch you guys rip into the study in a manner that makes a starving cheetah ripping into its prey look downright restrained by comparison? If I get the first chomps in, I can still sit back and watch you all have at it, as long as I leave just a bit left over for you. But, before I do, a wee bit of history.

Ever since the anti-vaccine movement started backing away the now thoroughly discredited claim that the thimerosal in preservatives cause autism and the even more thoroughly discredited claim that the MMR vaccine causes autism and pivoted to readjust its reality to embrace the idea that it's all about "too many too soon" and "toxins" in vaccines (even though that's scientifically unsupported too), they've been clamoring for what they like to call a "vaxed-unvaxed study." Basically, this is a study of vaccinated children versus unvaccinated children. At first, having no concept of medical ethics, anti-vaccine activists demanded a prospective, randomized, double-blind, placebo-controlled trial, apparently not realizing how utterly unethical such a study would be, given that it would leave the placebo control group unprotected against potentially dangerous childhood illnesses. Eventually, it started to sink in that such a study is neither feasible nor ethical (although sadly this wasn't the case for all anti-vaccine loons). When that finally happened, it was so cute to see anti-vaccine activists try to propose epidemiological studies. Basically, it's painfully obvious that anti-vaccine activists don't understand the issues involved, particularly the size of the study that would be required, the difficulty in controlling for confounding factors in the sorts of designs that would be required (such as case-control, for example), and how expensive such a study would be. Also, to meet ethical standards, such a study would have to have a decent amount of preliminary data to support its hypothesis that vaccines cause autism (or whatever), and there is none, at least none not coming from anti-vaccine loons or investigators somehow associated with anti-vaccine loons.

Not that that's totally stopped anti-vaxers from trying to do such a study.

For example, four years ago, J.B. Handley's (now Jenny McCarthy's) anti-vaccine propaganda group Generation Rescue did what was billed as a "study" of vaccinated versus unvaccinated children. It was nothing of the sort. Rather, it was a poorly designed phone survey whose results in some groups suggested that vaccines protected against autism, although Generation Rescue spun it as supporting the vaccine-autism hypothesis. Of course, the whole survey was so ridiculously badly designed that you really couldn't tell anything from it at all, given its selection bias and failure to control for confounders, but that doesn't stop it from periodically rising from the grave and shambling off to feast on the brains of antivaxers, who then cite it as though it's evidence of anything other than the incompetence of Generation Rescue at any sort of research.

Now they're at it again, although it's not Generation Rescue who did this new "study." Even so, not surprisingly, the anti-vaccine propaganda blog Age of Autism is nonetheless promoting it under the title Vax UnVax Study Results, as is the one anti-vaccine website that can challenge NaturalNews.com for the sheer intensity of its burning stupid, Child Health Safety, which is promoting the study/survey breathlessly as New Survey Shows Unvaccinated Children Vastly Healthier - Far Lower Rates of Chronic Conditions and Autism.

It does nothing of the sort.

In fact, looking at the actual survey used, although it pains me to say so, Generation Rescue comes out looking more competent than VaccineInjury.info, the English-language version of Impfschaden.info, a German anti-vaccine website run by a homeopath named Andreas Bachmair, who conducted the survey. You'll see what I mean in a minute. The survey begins with this introduction:

For statistical evaluation of the state of health of entirely unvaccinated children we request you to fill out the following form. The data will be published anonymously and handled with utmost confidentiality. The results help us to acquire accurate information about the health of unvaccinated children.

Does anyone see a problem here? Well, actually, does anyone see several problems, but one glaring problem besides the problem of this being an anonymous Internet survey that anyone can fill out? Let's just put it this way. Even Generation Rescue tried to have an actual control group, namely vaccinated children. Indeed, although Generation Rescue did a crappy and arbitrary job of it, its survey company at least tried to stratify respondents into different dose levels of vaccines, to produce three groups: unvaccinated, partially vaccinated, and fully vaccinated. What does Bachmair do? Nothing of the sort! He only collects data on "entirely unvaccinated children." He even puts it in bold! Let's just say that the construction of this survey demonstrates in this survey all the scientific understanding and rigor that I would expect from a homeopath, given that homeopaths believe that magic water cures people.

Before I come back to the horrendously bad methodology, why don't we just summarize some of the results of this survey and then look at some of the reactions? There were a total of 7,762 children whose information was provided to the survey, and the general results are summarized as the state of health of unvaccinated children. Before we get to the "money results," let's take a peak at some anomalies that suggest that this particular group might not be--shall we say--strictly comparable to children in the population at large. For example:

The parents stated that their preferred treatment was naturopathic and homeopathic. Less than 10% said they preferred conventional medicine. Treatment in the "other" column was mainly chiropractic and supplemental.

So, right away, this survey demonstrates that the parents who filled it out were a self-selected, biased sample, the vast majority of whom favor alternative medicine and are hostile to scientific medicine. Indeed, 99.69% of the respondents report being happy that they did not vaccinate their children. One thing that this love of woo and hostility towards scientific medicine can mean is that a lot of these children could have subclinical or mildly clinical disease that goes undiagnosed because they never take their children to a real doctor, preferring instead homeopaths, naturopaths, and chiropractors.

To get a flavor of the health results, let's look at the part of the report that asks about asthma and atopic diseases:

Asthma, hayfever and neurodermatitis are seen very frequently today. A recent German study with 17461 children between 0-17 years of age (KIGGS) showed that 4.7% of these children suffer from asthma, 10.7% of these children from hayfever and 13.2% from neurodermatitis. These numbers differ in western countries, i.e. the prevalence of asthma among children in the US is 6% whereas it is 14-16% in Australia (Australia's Health 2004, AIHW)
The prevalence of asthma among unvaccinated children in our study is around 2.5%, hayfever 2.5% and neurodermatitis 7%.
According to the KIGGS study more than 40% of children between the ages of 3 and 17 years were sensitized against at least one allergen tested (20 common allergens were tested) and 22.9% had an allergic disease. Although we did not perform a bloodtest, around 10% stated that their children had an allergy.

One wonders how, if these parents chose homeopaths, naturopaths, and chiropractors over real doctors, they had any idea whatsoever whether or not their children actually had asthma. One of the most common presentations of asthma is cough alone. In fact, milder cases of asthma can be difficult to diagnose in children; so once again, what the parents report probably doesn't tell us much. Neither does the claim that far fewer of these children had allergies.

Which brings us to autism.

If you scroll down to the graph looking at autism and various other problems, such as ADHD, you'll find that the overall prevalence reported in these children was 0.57%. In terms of raw numbers, that's 44 children, which makes this statement rather puzzling:

There are also autism cases in unvaccinated children. However over 80% stated, that it is only a mild form or a high functioning form of autism. Among all participants there were 4 severe autism cases.

Apparently, basic math isn't a homeopath's strong suit, which probably explains why they can't understand the concept of Avagadro's number. Be that as it may, if 20% of autistic children equals four, then there could only be 20 autistic children, but the survey suggests that there were twice that many in unvaccinated children. (One wonders what Tony Bateson would say.) In any case, a prevalence of 0.57%, even if this survey were accurate, would be within the range of estimated prevalences found in various studies. Perhaps Bachmair knows that, which is why he tried to emphasize "severe" autism and then came up with those additional factoids about some of these four to suggest that they had been exposed to mercury or heavy metals. Even worse for Bachmair, if you look at the graph of autism by age range in these children, depending on the age range it ranges from 0.37% to a whopping 2.36%, the latter of which is almost as high as a recent study in Korea found. In fact, if you look at the age range of the responses, nearly half of the responses (3,075) were for children under two years old, which is young enough that autism might very well have not been diagnosed yet, and in this group the reported prevalence was 0.37%, while in the 11-12 year range the prevalence was highest, at 2.36%. In fact, autism prevalence is so obviously not appreciably different in the unvaccinated in this survey compared to reported prevalence numbers that even a commenter at Age of Autism wrote:

If you look at all the age groups >2 years old the autism incidence ranges from 0.63 to 2.36%, with most being in the range 1-2%, the population size was about 3500 replies. My main criticism is a self selected population with potentially varying diagnostic criteria, but on these data the incidence of autism in unvaccinated children seems to match vaccinated children.

There's no "seems" about it. The prevalence of autism in unvaccinated children in this survey does closely match reported numbers for overall population prevalence in populations where the vast majority of children are vaccinated. This result is an unmitigated disaster for Bachmair and his groupies, which is why I couldn't stop laughing when I read this from ChildHealthSafety:

It is interesting neither the US National Institutes of Health [US$30.5 billion annual budget on medical research] nor the US Centers for Disease Control [US$11 billion budget annually] could find the time or money to fund this kind of research but instead waste US tax dollars on a great deal of pointless medical research and promotion of iatrogenic [man made] disease causing agents [modern drug company "treatments"].

No, it's not really that interesting. Say what you will about the NIH, it does have a pretty rigorous peer review process, which means that it doesn't (usually) fund crap. In fact, this survey was so poorly designed and analyzed that I doubt even the National Center for Complementary and Alternative Medicine (NCCAM) would fund it. Unfortunately, now this "study" will no doubt join the Generation Rescue "study" in the annals of crap vaccine/autism science, to circulate around Whale.to (where it belongs) and be dredged up as "evidence" periodically. Old, refuted anti-vaccine studies never die, alas.

In any case, I take some comfort in the hilarious result of this survey that demonstrates that autism prevalence in the unvaccinated is similar to autism prevalence among the vaccinated, no matter how much anti-vaccine activists try to spin it otherwise. I realize that this survey is in fact so poorly designed that it really doesn't tell us much of anything, but it is fun watching anti-vaxer brains explode trying to spin this result as supporting the vaccine/autism hypothesis.

The enjoyment I get watching that assuages my guilt for picking on homeopaths so.

NOTE: I notice that the total number of children is increasing. It's now up to 7,799 at this moment, suggesting that 30 people have filled it out since last night. Given that Child Health Safety lists it as 7,724 five days ago that suggests that the surveys still open and is automatically updating totals.

Hmmmmm.

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With all (heaps and heaps) of due respect Orac, I think Matt has a point although it's not so much you as your commentators who need to 'check their tone', especially lilady who's like a playground bully!

Offensiveness is more offensive when presented alongside good science. Be friendly and let the science say the mean stuff!

Every neuron in my brain says that your science is to be followed but my tummy is asking me to look around for your victims - they need a cuddle!

Point nicely illustrated lilady.

Now why do I want to go out and spread anti-vaccine information despite knowing that it is wrong?

Because you are close and present wrongness, I feel like running to the other side. Granted, my science is soft as your buttocks but it is still a hard emotional fact.

What would a manga character like me be doing with hard science anyway? I've got a magic hankie.

The science doesn't help because vax/anti-vax are emotional issues so it will take emotional intelligence to win them over, not logical correctness.

Look, I only mentioned your buttocks because I assume the 'lil' from lilady refers to your height and not your circumference.

Julian (I love that name btw!), yes I'm sure you are right there are some nasty dangerous characters in there. Since when did nastiness fix nastiness?

Only love can trump fear. I wholeheartedly believe that the CFA movement will reduce the power of the VRM in a way that SBM cannot!

Why not compromise? Vaccines probably cause less than 1 in 9,000 cases of medical conditions which may be diagnosable, at a stretch, as autism-like.

Which means, lilady, that you are superfluous to requirement on this forum now that Yucie has arrived.

Adjudging mental derangement in you opponents is your standard tactic. It's old and stale and doesn't help much with the community care of people who are genuinely having mental or emotional problems.

You've mentioned your buttocks twice now. Along with my two, that's 8 altogether. 8 of mine are equal to one of yours.

I guess he does it because he can. Information is like a naughty child, always trying to escape and play ;)

lots of great information / points . but i can smell the atheist on your breathe . secular humanist if you prefer .

By jason roberts (not verified) on 14 May 2012 #permalink

i can smell the atheist on your breathe

I can smell The Stupid on yours.

Seriously though, this site is frequented by both theists and atheists (I personally am an atheist). What does that have anything to do with the content of this year-old post you decided to comment on?

No real name Orac? Coward. I live by the simple theory that I own my body and get to choose what I put in it. You don't get to force me to put anything I don't want in it. Besides if vaccines work and you take them, aren't you protected against whatever bad juju they say it protects you from? What does it matter if I take the risk of not taking the vaccine if they really work? You took the vaccine, you're protected right? If you force me or anyone else to take your chemical cocktails then you are an authoritarian and I reject you are your BS.

Pretty much anyone and everyone knows who Orac is. Took me about 15 seconds back when. Go back to Google U and study harder.

By Kelly M Bray (not verified) on 15 May 2012 #permalink

No real name Orac? Coward.

signed RJ

Idiot.

Not to mention RJ's complete lack of understanding of simple concepts such as herd immunity, or more simply, helping protect those who can't be vaccinated.

Iiiiiiiiiiiiiiiiiidiot. Or just a bad Poe. I offer no bet either way.

By Scottynuke (not verified) on 15 May 2012 #permalink

"Besides if vaccines work and you take them, aren't you protected against whatever bad juju they say it protects you from? What does it matter if I take the risk of not taking the vaccine if they really work?"

You may have seen those little human beings around - called babies? They are too young to be vaccinated, and people are fond of them - and would rather not see them sicken and die from diseases spread by creatures too lazy or cowardly to take the simplest steps to protect them.

What does it matter if I take the risk of not taking the vaccine if they really work? You took the vaccine, you're protected right?

We really need a FAQ. Or maybe a FRSA (Frequently Refuted Stupid Arguments).

First of all, vaccines "really work," but like just about everything else on this planet, it cannot provide 100% effectiveness. If you were wearing a bulletproof vest that harmlessly stopped 99% of the bullets fired at you, would you say "Oh, go ahead, everyone who wants to fire off bullets at me, just feel free!"? What would you do if 100 people took you up on the offer?

Second of all, as others have already pointed out, not all of those who need the protection of vaccines are people who can actually take them. Small babies, people with rare irregularities of the immune system, people immuno-compromised by disease or following organ transplant - these people may not be able to receive all vaccines directly. But if the people around them get vaccines, they do receive protection; it's like putting up roadblocks on all the routes infection might take to get to them.

By Antaeus Feldspar (not verified) on 16 May 2012 #permalink

The doctors and scientists here are so arrogant that it makes me laugh - the very fact of your arrogance and utter certainty of your positions make it obvious that you should go back and take more science history. Science is always changing positions based on new evidence and studies.

You criticize the studies as being unscientific but in the same breath say that a truly scientific study is too expensive and not feasible - if you won't be an upstanding doctor and scientists and push for clinical trials to resolve the debate then you are no better than the pseudo scientists you condemn.

By oldpatriot (not verified) on 16 May 2012 #permalink

#192: If you're truly an "old patriot", as you claim, then you can tell me about polio and measles.

By Gray Falcon (not verified) on 16 May 2012 #permalink

What debate do you feel needs to be resolved, oldpatriot? With respect to homeopathy the debate is settled: not only is there absolutely no credible evidence it works, but for it to work as describied (prinicple of similars, law of infinitesimals, etc.) not only would everything we know about molecules, dilution, chemistry, biology, etc., have to be wrong it would have to be spectacularly wrong.

And while it's true our understanding of the natural universe contimues to be expanded and refined, science isn't always changing positions: instead it's quite rare that a well established model has to be abandoned in light of new observations.

"Science is always changing positions based on new evidence and studies."

Perhaps "oldpatriot" could apply that statement to epidemiological studies and answer "Gray Falcon's" questions about measles and polio incidence before vaccines were developed...and after vaccines were developed, to prevent these diseases.

@ JGC:

Not only is there absolutely no credible evidence it works, there is a great deal of direct evidence that it does not.

If your collective goal on both sides of the fence is to keep kids safe and if you are all so certain you are correct then WHY not collectively advocate for a comprehensive study of unvaccinated vs vaccinated that meets all of your strict, flaw proof criteria?

Why continue to attack and undermine attempts at data collection? Any effort at solving this mystery is better than NONE.

I do not understand the unwillingness on the pro-vax side to seek definitive answers. There have been NO STUDIES the answer the mystery. Only very busy attempts to thwart every effort. Your pro-vax studies are just as easy to tear apart and discredit because they also do not address the critical issue. To claim otherwise is so dishonest and biased.

Joyce--

It is precisely because we want to keep people—not just kids, people of all ages—safe that we aren't advocating a vaccinated-versus-unvaccinated study of the sort you are calling for. Such a study would risk large numbers of lives, to confirm what we already know. You cannot ethically do a study of that deprives half the subjects of life-saving treatment, giving them only a placebo, in order to confirm that people who don't get the treatment are more likely to die.

We don't re-confirm the need for clean water by deliberately giving randomly selected children water that contains feces and cholera. And we don't confirm that bullet wounds are bad for you by grabbing volunteers, shooting some of them from 10 meters, and firing guns with blanks at the rest.

If someone proposed either of the things in the paragraph above, both doctors and laypeople would be justly horrified.

We already know that vaccines save lives and that they don't cause autism. If you were saying "run a test, because I'd rather my child be dead than autistic," that would be bad enough. What you're actually asking is that we run a test, because you'd rather your child be blind and autistic than sighed and autistic, you'd rather they be miserable with chicken pox and autistic than be autistic but not suffer chicken pox.

If your collective goal on both sides of the fence is to keep kids safe and if you are all so certain you are correct then WHY not collectively advocate for a comprehensive study of unvaccinated vs vaccinated that meets all of your strict, flaw proof criteria?

Two reasons: it would be unethical and it isn't necessary.

It would be unethical to conduct a study where children were given placebo injection in lieu of routine childhood immunizations because doing so places them at risk of serious illness, injury or death.

It also isn't necessary to conduct such a comprehensive study, given that we already have an extremely large body of evidence from a multitude of previous studies assessing the safety and efficacy of immunization.

There have been NO STUDIES the answer the mystery.

Yes, there have: every vaccine approved by the FDA and/or EMEA for marketing and use has been through Phase I, II and II clinical trials. Large scale epidemiologic studies assessing the safetty of vaccines post-approval have been completed as well (for example, Hviid et all looked at every child born in Denmark between 1990 and 1996--a total of 467,000 individuals--when investigating a possible association between thimerosal adjuvants and autism). Add to that the fact that post-marketing surveillance continues to monitor vaccine safety: your 'mystery' is being rigorpusly addressed without the need to conduct unethical trials.

@joyce

Your pro-vax studies are just as easy to tear apart and discredit because they also do not address the critical issue.

[citation needed] from a well-regarded scientific journal, or you are just another brain dead anti-vaxer.

@Joyce - You do understand that such a study as the anti-vax folks advocate would be the same as what was done during the infamous "Tuskegee Study," don't you?

It would require a large number of children in a "double-blind" environment, where 1/2 would receive vaccines and the other would receive nothing but placebos. If there was an outbreak of disease, such as measles or mumps among the groups, it would be impossible to know, as a parent, if my child was actually protected.

If one or more of these children died or was seriously harmed by becoming infected, it would be a serious lapse in ethics (not that the study itself would be a serious lapse as well).

Please care to explain how this type of study could be done ethically, to the standards that are demanded?

Hello! I really appreciate the scientific analysis that you propose on this issue. owever, being a father of a six month baby boy, I still don't feel secure about vaccines. There are several reasons for this, but the main reason is that I witness very often manipulation of the info in the mass media. More reasons : Can we trust our doctors when they get percentage for promoting certain drugs? I also found numerous articles on google scholar on social control through medical practice and methodology, since the 18th century! Wouldn't it be more scientific of you to put these findings in test mode in a larger socio-economic and historical context? Two recent scandals in France show how far the pharmaceutical lobby can go for cash : Flu A and Mediator...It's easy as you say, to attack worrying citizens who maybe react to manipulation by...manipulating facts also. In advertising, false scandals create effective publicity...Calling someone "stupid" publicly belongs to a scientific deontology?!
What about the long term effects : are there studies that examine the immune system response to inflammation of vaxed population? and is it even possible to conduct such a study? If it's anethical to make a study as cited many times above, wouldn't we have to apply the precautionary principle? I also saw a documentary on french national TV where one of the old members of Pasteur institut was upset about replacing the calcium phosphate in the vaccines by aluminium... Why put inside something potentially toxic instead of something non toxic? And finally about the capacity of scientists to conduct non biased info : is it true that Monsanto has bought Beeologics laboratory, after being accused for the death of bees?! (If that's true, I don't need to comment...) I have not decided yet who's right or wrong, but I know things are not just black or white, and I keep searching. I hope you too.

@Dimitri:

Can we trust our doctors when they get percentage for promoting certain drugs?

Do they? I'd like to see evidence of that, particularly since there are rules preventing that.

What about the long term effects : are there studies that examine the immune system response to inflammation of vaxed population? and is it even possible to conduct such a study?

Probably. You'd have to check on PubMed though.

If it's anethical to make a study as cited many times above, wouldn't we have to apply the precautionary principle?

The effectiveness of vaccines in reducing the incidence of disease has been demonstrated multiple times in the real world. You forget that not vaccinating has major risks. In fact, the Precautionary Principle argues for vaccination, not against it.

Why put inside something potentially toxic instead of something non toxic?

The dose makes the poison. The amount of aluminium salt in the entire schedule is less than you would get from eating a banana. The reason for adding an adjuvant is that it heightens the immune response, lowering the amount of biological material needed in the vaccine.
I hope I have answered your questions satisfactorily.

Saw this yesterday. Hilarious! I ended up tweeting a new "Find the Biases!" game with a link to it.

Gotta wonder what the hell they were thinking putting it up on their site. They really have no clue about science at all. Even I, a non-scientist, was able to pick out the problems that make it absolutely useless for anything other than laughs.

To be fair to the point of absurdity, 40 of 44 is "over 80%".

By Andreas Johansson (not verified) on 31 Aug 2011 #permalink

Ahhh -- terrible "science" gets its due. Thanks, lovely to see!

I've been following another theater of the global struggle against pseudoscientific nonsense, climate-change denial. The parallels are very interesting.

The latest flap is that a paper came out from CERN suggesting that cosmic rays may nucleate clouds more efficiently than had been thought. Clouds slow global warming, so if the cosmic rays had been decreasing, it might offer an alternate explanation for the rise in global mean temperature.

Problem is, the cosmic ray flux shows no particular trend (except the usual 11-year solar modulation), so it can't have much to do with the temperature change.

Yet the vast PR machine pushing back against science immediately pushed it as a talking point, because hey, who's going to actually look at it? All they have to do is spin the result, and their hordes of zombie trolls repeat it ad nauseum on the internet.

That paper was competent, but the "think" tanks spun it into something that it was not. But there are also several Wakefield-equivalents in the field, basically cranks with PhDs (a PhD does not inoculate you, heh heh, from crankitude) who publish crappy papers 'disproving' global warming, occasionally getting them past a sleeping referee. The Gerlich and Tscheuschner (that's a lot of consonants there!) paper 'falsifying' greenhouse gas theory was a classic example -- I can't think of another physics paper anywhere in the literature that was such unadulterated drivel.

Best to all. Keep 'em flying!

By palindrom (not verified) on 31 Aug 2011 #permalink

Be that as it may, if 20% of autistic children equals four, then there could only be 20 autistic children, but the survey suggests that there were twice that many in unvaccinated children.

False dilemma? Could there be three or more categories of autism, e.g. mild, medium, severe? That could account for that particular peculiarity, not that it affects the general conclusion at all.

By Randy Owens (not verified) on 31 Aug 2011 #permalink

This wreck of a study shows sham science in ascendency. For something as foolish and flawed as this thing to be touted in any way by any organization shows either the bankrupt nature of the organization, the dismal status of science education or both. For a naturopath, it is certainly both.

I'd have more respect for these idiots if their summary of findings was honest. Something like this would make me happy:

"In a self-selected, biased, unadjusted online survey open to any and all who are willing to spit in the face of the science behind epidemiology, biostatistics, and survey design, it was found that those interested in filling out the survey used their recall and confirmation bias to support our unfounded assertions that children who are unvaccinated are healthier than vaccinated children. Further well-reasoned, expertly-designed, controlled, adjusted, and validated studies - which have been done ad nauseum by scientists and published in proper peer-reviewed journals - need only be read to dispel our myth."

That would be awesome.

Not only is it updated totals, it's changing the results. I just looked at the chart you discussed, and it shows the prevalence of autism as .56 rather than .57. Perhaps not a significant difference, but still. Perhaps they will try to keep adding data until they get data they like?

If they don't go to a regular doctor, how do they even know if their child has autism or ADHD?

@Tina S,
You have pointed out a sapling in a forest of stupid.

Todd W's "Find the Biases" game is more to the point. In fact a "Find the Errors" would be a more general purpose game in which you just scored a point.

BAHAHAHAHA! Honestly - when even a horribly biased, pseudoscientific study designed to support your dubious theory show that it's wrong, that would be a signal to anybody but an anti-vaxxer that it's time to let it go already.

By edith prickly (not verified) on 31 Aug 2011 #permalink

Anti-Vax fails even in their own, poorly designed "studies". How sad. Expected but sad.

By Poodle Stomper (not verified) on 31 Aug 2011 #permalink

But the CATS study ( THAT FUNNILY ENOUGH YOU NEVER BOTHERED TO ANALYZE) didn't backfire so spectacularly. You are cherry picking!

CATS study? The one that suggested "environmental causes" but didn't point to vaccines in particular?

By Gray Falcon (not verified) on 31 Aug 2011 #permalink

I suspect jen still hasn't read or fully understood the study, based on her continuous ignorant spoutings of misinformation.

But the CATS study ( THAT FUNNILY ENOUGH YOU NEVER BOTHERED TO ANALYZE) didn't backfire so spectacularly. You are cherry picking!

@ jen, this has been discussed on other blogs; it doesn't suggest what you think. Besides, even if Orac did dissect it, you wouldn't comprehend nor accept his interpretation. So why don't you analyse it yourself or get one of your AoA mates to spoon-feed you.

@Jen,
It isn't really cherry picking when the cherries are inches deep all over the ground, ripe, and so delicious. This study is terminally flawed. CATS was too.

Gray Falcon, of course the study didn't point to vaccines in particular. Science mom- so what other science blogger analyzed it??

@ Science Mom and others: AoA has already done an analysis of the CATS study as jen well knows and "jen" has already commented about the study at AoA:

"I'm waiting.. Waiting for Nancy Snyderman Matt Lauer and the Today show to discuss this important news. Or what about Sanjay Gupta or Anderson Cooper? I'm pretty sure Paul Offit won't be bringing it up and Orac is busy talking about anything other than this. Bullshit! (you can edit out that word of you want)." (jen, July 16, 2011)

Busted!

Lilady, so what? What is your point? I asked what other science blogger analyzed the study. Or is your comprehension that skewed?
Wow, I feel so Busted! Not.

I still think jen still doesn't understand what the hell she is talking about.

Considering that she has spammed her comments about the CATS study over several blogs, has been corrected several times about what the results of the study means, and still spamming blogs with her utter ignorance about said topic, repeating her incorrect assertions again and again, I think that jen really needs to read the study and actually understand what it is actually saying.

Anyways, back on topic, does it seem like they are keeping the survey open so that they can get the results that they want? Seems like that to me

While most of us can easily find fault with these studies ( for obvious reasons), they are lapped up like top cream from raw milk by the alties *because* they have an entirely different mindset- i.e. their system of explaining "how the world works"- than we have. That includes understanding and use of statistics to test hypotheses. That includes the definition of "evidence". Oh, I could go on.

The point is we speak another language and I think that we need to deal with that. What we say cannot be instantly translated into *altspeak* because it rests upon a foundation of certain abstract concepts ( think "formal operational thought") that they don't use.

A certain writer ventured that people think like "naive scientists" testing hypotheses to explicate the workings of events physically and socially. I should add: in some cases, *very* naive scientists.

By Denice Walter (not verified) on 31 Aug 2011 #permalink

Jen, "environmental causes" can mean a wide variety of things, up to and including the culture one is raised in.

By Gray Falcon (not verified) on 31 Aug 2011 #permalink

@Gray Falcon,
Your mention of the culture one is raised in prompted a vision of Jen is a petrie dish of agar. Couldn't help it. Just popped in there.

Novalox, you just said a whole lot of nothing. I asked lilady to show me a Science Blog analysis of the study. None of you have provided me with anything, so does one exist???? Yes or no. I can appreciate your point Gray Falcon. As someone named Dianne said awhile ago, " I will give the anti-vaccers this: twin studies don't get a 100% concordance suggesting that there is some sort of environmental or possibly epi-genetic component involved. Why they should pick vaccines as that..." (July 13, 11:07).
It just seems very lame that a science blog person such as Orac would go after a survey like this, but doesn't analyze something like the CATS study. Definitely cherry picking.

What's your point?

I imagine that Jen's point, as usual, is "hmmmmmmm."

I don't know what study is worse: this phone survey or the double-blinded, placebo-free acupuncture study I read a while ago. How do you blind the acupuncturist, especially when there's no sham acupuncture placebo? Do you put one eye patch on their left eye or two? Of course, the end results were favorable because it was in an acupuncture journal. Anyway, I'll try to find this study and post it when I can.

Ha. It is not every day we can rip into the science free zone of Orac's brain [aka pharma's very own Homer Simpson of the blogosphere, Orac] - But that is only because we don't usually have the time - no other reason - aside from the difficulty locating it.

Orac is apoplectic as usual. So not a reliable source to start with but it gets worse. Wot a nutter.

His near 2500 words we can encapsulate in a few quotes.

First the abusive rhetoric and derision which is the main basis for all his arguments.

"a study that's just so mind-numbingly, brain-meltingly awful"

"the sheer intensity of its burning stupid"

"a starving cheetah ripping into its prey look downright restrained"

"anti-vaccine loons" "anti-vaxers"

".... they've been clamoring for what they like to call a "vaxed-unvaxed study."

"Now they're at it again"

"anti-vaccine propaganda"

"now this "study" will no doubt join the Generation Rescue "study" in the annals of crap vaccine/autism science, to circulate around Whale.to (where it belongs) and be dredged up as "evidence" periodically."

Then we get the "scientific" criticisms [Ha] buried in Orac drivel:-

"the whole survey was so ridiculously badly designed that you really couldn't tell anything from it at all"

"an anonymous Internet survey that anyone can fill out? Let's ... have an actual control group, namely vaccinated children."

"Generation Rescue did a crappy and arbitrary job of it"

"a poorly designed phone survey"

"entirely unvaccinated children."

"Less than 10% said they preferred conventional medicine."

"the parents who filled it out were a self-selected, biased sample, the vast majority of whom favor alternative medicine"

"99.69% of the respondents report being happy that they did not vaccinate their children"

So wee Orac, if you don't like it its about time we had a well funded independent objective and impartial study done. Stop complaining when independents take a crack at it. Its their taxes which are being spent wasted on the vast amount of useless medical research [genetics is a prime candidate along with cancer and psychiatry - the latter being the least successful branch of medicine in history].

And don't fob the public off with the usual unscientic junk studies put out in drug industry funded medical journals to claim everything apart from Orac's brand of medicine is valid - people are voting with their feet - OracCare kills people and injures them in droves in the USA with adverse drug reactions and botched procedures

Then Orac spews out in a rant the usual complete tosh to justify the nonsensical claim that:

".... such a study is neither feasible nor ethical"

But this is the real hoot. These children might really have asthma but because they don't have any symptoms their parents don't know. Ha ha ha ha ha ha .....:-

"a lot of these children could have subclinical or mildly clinical disease that goes undiagnosed because they never take their children to a real doctor"

"One of the most common presentations of asthma is cough alone" .... "milder cases of asthma can be difficult to diagnose in children".

"what the parents report probably doesn't tell us much. Neither does the claim that far fewer of these children had allergies."

What the Mighty Officials of OracCare did not tell you is that asthma and allergy have increased so dramatically in the 25 or so years since the late 1980s drive for vaccination that his profession in the UK were instructed just a handful of years ago to go out and look for as many cases as possible. The Mighty Officials then wanted to use the increased statistics to claim the science shows it was all greater awareness and better diagnosis. LOL.

And then Orac reveals he has had an analytical skills total bypass from birth and his math education was wasted. He says:

"Apparently, basic math isn't a homeopath's strong suit ..... if 20% of autistic children equals four, then there could only be 20 autistic children, but the survey suggests that there were twice that many in unvaccinated children."

Really Orac? Let's see what he bases this on and show that Orac's math is sadly a long way from his strong point [if he has one].

The numbers cited are entirely in keeping with the text:

-

  • there were 44 children reported as having an autistic condition
  • -

  • over 80% of parents reported the autistic conditions in children were mild and of the Asperger type.
  • -

  • only 4 were reported as having severe autism
  • What does that tell us?

    -

  • Over 80% means 35 of the 44, leaving 9 or less cases.
  • -

  • 4 of the 9 were reported as having severe autism.
  • -

  • That leaves 5 cases where 1) either the parents did not say what kind of autistic condition their child had or 2)there were less than 5 cases of severe autism in those 5 or both.
  • -

  • Let's say it was 5 cases and the parents did not say. At over 80% the probability is of those 5 cases 4 were mild, leaving 1 which might be the more severe autism.
  • So Orac, 4 cases of severe autism or even 4 +1 is not 20% but that is still consistent with "over 80%" of parents reporting mild autistic conditions.

    And here is another hoot:

    a prevalence of 0.57%, even if this survey were accurate, would be within the range of estimated prevalences found in various studies.

    0.57% is 1 in 175. But wait a mo'. In the USA the figure is nearly half that at 1 in 100. In the UK the figure is a third of that at 1 in 64.

    And Orac, these figures reflect the kinds of differences seen in the Generation Rescue telephone survey you decry don't they?

    And in the UK 30% of autistic conditions are the more severe autism - in the US we understand the number is higher.

    Yet for the unvaccinated this survey suggests the number [4 cases or less than 10%] is 300% lower or 1 in 2000 cases which is close to the pre vaccine era of 4 in 10,000. And the affected children had higher exposure to mercury or heavy metals.

    And this OracDrivel is a hoot too:-

    autism prevalence is so obviously not appreciably different in the unvaccinated in this survey compared to reported prevalence numbers

    When Orac in the same passage notes that:-

    depending on the age range it ranges from 0.37% to a whopping 2.36%, ..... 3,075 were for children under two years old, ... autism might very well have not been diagnosed ... the reported prevalence was 0.37%, while in the 11-12 year range the prevalence was highest, at 2.36%.

    But at the same time ignores that in the 15-16 year age group the figure is 0.62%.

    But that does not stop the science free zone between Orac's ears from concluding so stupidly it burns:

    The prevalence of autism in unvaccinated children in this survey does closely match reported numbers for overall population prevalence in populations where the vast majority of children are vaccinated.

    This result is an unmitigated disaster for Bachmair and his groupies ...

    But hang on Orac old boy, didn't you just say a mere few million drivel points earlier hidden in abuse and rhetoric that:

    "the whole survey was so ridiculously badly designed that you really couldn't tell anything from it at all"

    We told you he is a nutter. That demonstrates it - the stupid it burns.

    And what is Orac and his band of amateur night pseudo-scientists going to do. Yep you guessed it they are going to sabotage this genuine effort to get data that everyone has been clamouring for for years.

    How do we know? OracCare's postscript to his blog:-

    NOTE: I notice that the total number of children is increasing. It's now up to 7,799 at this moment, suggesting that 30 people have filled it out since last night. Given that Child Health Safety lists it as 7,724 five days ago that suggests that the surveys still open and is automatically updating totals.

    I find this statement rather interesting:

    There are also autism cases in unvaccinated children. However over 80% stated, that it is only a mild form or a high functioning form of autism. Among all participants there were 4 severe autism cases.

    The survey didn't ask for "severity" of autism. I doubt that all of the parents reporting on their autistic kids volunteered this information. Such surveys usually don't get a lot of extra information like that. People tend to just fill in the bubbles and move on. This leaves the organizers of the survey contacting these participants for information (and, 100% response rate).

    Ha. It is not every day we can rip into the science free zone of Orac's brain [aka pharma's very own Homer Simpson of the blogosphere, Orac.

    Either Orac's has opened a new Blog in South Africa or someone has pasted his latest rant on the one this pingback on CHS is from.

    Orac is apoplectic as usual. So not a reliable source to start with but it gets worse. Wot a nutter.

    His near 2500 words we can encapsulate in a few quotes.

    First the abusive rhetoric and derision which is the main basis for all his arguments.

    "a study that's just so mind-numbingly, brain-meltingly awful"

    "the sheer intensity of its burning stupid"

    "a starving cheetah ripping into its prey look downright restrained"

    "anti-vaccine loons" "anti-vaxers"

    ".... they've been clamoring for what they like to call a "vaxed-unvaxed study."

    "Now they're at it again"

    "anti-vaccine propaganda"

    "now this "study" will no doubt join the Generation Rescue "study" in the annals of crap vaccine/autism science, to circulate around Whale.to (where it belongs) and be dredged up as "evidence" periodically."

    Then we get the "scientific" criticisms [Ha] buried in Oracdrivel:-

    "the whole survey was so ridiculously badly designed that you really couldn't tell anything from it at all"

    "an anonymous Internet survey that anyone can fill out? Let's ... have an actual control group, namely vaccinated children."

    "Generation Rescue did a crappy and arbitrary job of it"

    "a poorly designed phone survey"

    "entirely unvaccinated children."

    "Less than 10% said they preferred conventional medicine."

    "the parents who filled it out were a self-selected, biased sample, the vast majority of whom favor alternative medicine"

    "99.69% of the respondents report being happy that they did not vaccinate their children"

    So wee Orac, if you don't like it its about time we had a well funded independent objective and impartial study done. Stop complaining when independents take a crack at it. Its their taxes which are being spent wasted on the vast amount of useless medical research [genetics is a prime candidate along with cancer and psychiatry - the latter being the least successful branch of medicine in history].

    And don't fob the public off with the usual unscientic junk studies put out in drug industry funded medical journals to claim everything apart from Orac's brand of medicine is valid - people are voting with their feet - OracCare kills people and injures them in droves in the USA with adverse drug reactions and botched procedures

    Then Orac spews out in a rant the usual complete tosh to justify the nonsensical claim that:

    ".... such a study is neither feasible nor ethical"

    But this is the real hoot. These children might really have asthma but because they don't have any symptoms their parents don't know. Ha ha ha ha ha ha .....:-

    "a lot of these children could have subclinical or mildly clinical disease that goes undiagnosed because they never take their children to a real doctor"

    "One of the most common presentations of asthma is cough alone" .... "milder cases of asthma can be difficult to diagnose in children".

    "what the parents report probably doesn't tell us much. Neither does the claim that far fewer of these children had allergies."

    What the Mighty Officials of OracCare did not tell you is that asthma and allergy have increased so dramatically in the 25 or so years since the late 1980s drive for vaccination that his profession in the UK were instructed just a handful of years ago to go out and look for as many cases as possible. The Mighty Officials then wanted to use the increased statistics to claim the science shows it was all greater awareness and better diagnosis. LOL.

    And then Orac reveals he has had an analytical skills total bypass from birth and his math education was wasted. He says:

    "Apparently, basic math isn't a homeopath's strong suit ..... if 20% of autistic children equals four, then there could only be 20 autistic children, but the survey suggests that there were twice that many in unvaccinated children."

    Really Orac? Let's see what he bases this on and show that Orac's math is sadly a long way from his strong point [if he has one].

    The numbers cited are entirely in keeping with the text:

    -

  • there were 44 children reported as having an autistic condition
  • -

  • over 80% of parents reported the autistic conditions in children were mild and of the Asperger type.
  • -

  • only 4 were reported as having severe autism
  • What does that tell us?

    -

  • Over 80% means 35 of the 44, leaving 9 or less cases.
  • -

  • 4 of the 9 were reported as having severe autism.
  • -

  • That leaves 5 cases where 1) either the parents did not say what kind of autistic condition their child had or 2)there were less than 5 cases of severe autism in those 5 or both.
  • -

  • Let's say it was 5 cases and the parents did not say. At over 80% the probability is of those 5 cases 4 were mild, leaving 1 which might be the more severe autism.
  • So Orac, 4 cases of severe autism or even 4 +1 is not 20% but that is still consistent with "over 80%" of parents reporting mild autistic conditions.

    And here is another hoot:

    a prevalence of 0.57%, even if this survey were accurate, would be within the range of estimated prevalences found in various studies.

    0.57% is 1 in 175. But wait a mo'. In the USA the figure is nearly half that at 1 in 100. In the UK the figure is a third of that at 1 in 64.

    And Orac, these figures reflect the kinds of differences seen in the Generation Rescue telephone survey you decry don't they?

    And in the UK 30% of autistic conditions are the more severe autism - in the US we understand the number is higher.

    Yet for the unvaccinated this survey suggests the number [4 cases or less than 10%] is 300% lower or 1 in 2000 cases which is close to the pre vaccine era of 4 in 10,000. And the affected children had higher exposure to mercury or heavy metals.

    And this OracDrivel is a hoot too:-

    autism prevalence is so obviously not appreciably different in the unvaccinated in this survey compared to reported prevalence numbers

    When Orac in the same passage notes that:-

    depending on the age range it ranges from 0.37% to a whopping 2.36%, ..... 3,075 were for children under two years old, ... autism might very well have not been diagnosed ... the reported prevalence was 0.37%, while in the 11-12 year range the prevalence was highest, at 2.36%.

    But at the same time ignores that in the 15-16 year age group the figure is 0.62%.

    But that does not stop the science free zone between Orac's ears from concluding so stupidly it burns:

    The prevalence of autism in unvaccinated children in this survey does closely match reported numbers for overall population prevalence in populations where the vast majority of children are vaccinated.

    This result is an unmitigated disaster for Bachmair and his groupies ...

    But hang on Orac old boy, didn't you just say a mere few million drivel points earlier hidden in abuse and rhetoric that:

    "the whole survey was so ridiculously badly designed that you really couldn't tell anything from it at all"

    We told you he is a nutter. That demonstrates it - the stupid it burns.

    And what is Orac and his band of amateur night pseudo-scientists going to do. Yep you guessed it they are going to sabotage this genuine effort to get data that everyone has been clamouring for for years.

    How do we know? OracCare's postscript to his blog:-

    NOTE: I notice that the total number of children is increasing. It's now up to 7,799 at this moment, suggesting that 30 people have filled it out since last night. Given that Child Health Safety lists it as 7,724 five days ago that suggests that the surveys still open and is automatically updating totals.

    @Rogo5

    Re: Blinding acupuncture studies

    There are actually sham needles that prevent the practitioner from seeing whether or not the needle has actually pierced the skin. The way a study like that would work is to use real needles with a sheath and sham needles with a sheath. The sham needles include a small amount of resistance at a point consistent with that felt using real needles. They have been validated for use in double-blind studies of acupuncture.

    Another way to go about a double-blind acupuncture study, although less rigorous than using sham needles, is to exclude the practitioner from any data collection/analysis and have the people collecting and/or analyzing the data blinding to which treatment the subject received. The drawback with this is, of course, that the practitioner may inadvertently break the blind by behaving or speaking in a manner differently when using the sham needles vs. the real ones.

    Well the "open" survey now has 7,799 participants...I think the 7,799th "child" might be "mine". I filled out the survey on behalf of my six year old...who is unvaccinated and has 10 siblings. I entered "yes" to every question about disturbed sleep, fussiness, medical issues and developmental diagnoses.

    I haven't had so much fun messing up a "survey" since I responded to a robocall from the Tea Party Voter Choice Telephone Survey.

    "I asked lilady to show me a Science Blog analysis of the study.
    Can't be bothered reading the CATS study...
    Can't be bothered searching Scienceblogs for someone else's analysis of the study...
    Kids today expect everything handed to them on a platter. I blame the parents.

    It just seems very lame that a science blog person such as Orac would go after a survey like this, but doesn't analyze something like the CATS study.

    Since Orac obtains his amusement from ripping apart pseudoscience and quackery, his failure to analyse the CATS study suggests that he does not consider it pseudoscience or quackery.

    By herr doktor bimler (not verified) on 31 Aug 2011 #permalink

    Well to be kind to Jen, can we infer that she feels that Mark Blaxill's "scientific analysis" at AoA really isn't isn't a "scientific analysis"?

    Here's another gem from "jen" posting at AoA:

    "Well now that the largest, most rigorous study has shown environment to be in fact more important than genes, I expect this new, updated and incredibly important information to start appearing STAT in anything published (CDC info, web MD, wikipedia, DSM's etc.) Oh, but they'll try and drag their heels, especially if it's anything owned by the Murdochs."

    Posted by: Jen | July 15, 2011 at 04:59 PM

    Why doesn't "jen" go to the Autism Speaks website...after all they funded the CATS study? I suspect that "jen" doesn't dare venture there, as AoA has embarked on another of its crusades to discredit any individual (Brian Deer, Orac) and any organization (Autism Speaks, IOM, IACC) that is not in lockstep with the craziness and sheer lunacy of those who blog and post at AoA.

    A few weeks ago, Jen was commenting on one of the scientific summaries / analyses of the CATS study that she doesn't know about now.

    By herr doktor bimler (not verified) on 31 Aug 2011 #permalink

    I just entered data on "another child" of mine on the open survey. This child is 10 years old, has four siblings and is vaccinated. My "10 year old child" has none of the problems listed on the survey and I ticked off "NO" on all the questions about behaviors, physical diagnoses and developmental diagnoses on the "survey".

    Should we inlcude a couple of children who died from complications to measles or whooping cough?

    i want to go and fill out the survey and explain that my child left many weeks ago during the rapture.

    "I haven't had so much fun messing up a "survey" since I responded to a robocall from the Tea Party Voter Choice Telephone Survey."

    I'd suggest (strongly) not doing this. The survey was enough of a failure on its own. No reason to give them the chance to cry "foul".

    even commenters on AoA see that this isn't supporting their position.

    right now, this survey is showing clearly that some people will promote any level of junk data. It really isn't putting them in a good light. Why mess that up?

    (Sorry Matt, too late) I just filled out another survey about my unvaccinated "child" and added a comment about the unvaccinated child's death from whooping cough. I ticked off "yes" to all the bogus theories about vaccines for my decision to not vaccinate and added a comment "vaccines are not in the bible".

    Kinda like payback for loading the dice, stacking the deck and contaminating the VAERS website.

    Herr doctor, thanks for the links. I did see the LBRB one, other one didn't go through. Point taken about pseudoscience or quackery.

    In short, Orac is a loser. He got himself a good education and set off on what he thought, at the time, was a good career path. But, like many focused people, he didn't make the effort to compare the situation he was currently in with the reality of the surrounding world.

    He became a Breast Cancer Surgeon - and as we all know, that's kind of like being a major DDT Manufacturer just before the EPA wakes up.

    Every day Orac gets out of bed and heads to work where he claims, on his website, that he "is a surgical oncologist specializing in breast cancer."

    Sounds impressive? It isn't. There is absolutely no recognized medical specialty known as "surgical oncologist." It is a made up term. One to soften, I think, the reality that there is a whole male dominated mini-industry promoting the horror of hacking off women's beasts as a health measure.

    The whole idea of breast cancer surgery is being challenged right now by studies conducted by the US government - as well it should be. The "Gold Standard" of breast cancer surgery is called the Halstead Procedure, which, in reality, draws a surgical line four inches above the naval, and a second line just below the collar bone. Everything between the lines is chopped off - down to the ribs, including all those 29 lymph nodes. "Mom" comes home from the hospital looking a lot different. Then, since all those lymph nodes are gone her arms are going to swell up to the size of her waist.

    But the family needn't worry. They won't have to look at "Mom" in her new ugliness for long, for the surgery itself released all those tumorous cancer cells that her body's immune system had encapsulated, into her blood stream spreading the cancer EVERYWHERE. So "Mom" will be heading back to the hospital where the same white-coated-stethoscope-around-the-neck doctor will now recommend $400,000 of chemotherapy (and could you stop by the hospital business office while you are here, and sign over the title to your home as guarantee of your co-pay please?).

    But, thank God, all this is on the way out. City Cemeteries won't be doing a boom business in "Mom we love you..." signage so much, now that the government, and hence insurance companies, have cut out those "annual mammograms" designed to scare young women into letting some ghoul stick needles into her breasts for so-called tests.

    More, needle biopsies themselves are death waiting in the wings. The action of some ham-handed, poke-a-lot, drooling(?) older male "surgical oncologist" jabbing, and jabbing, and jabbing, and jabbing, and jabbing, a biopsy needle into a soft tissue breast trying to find an actual tumor is a cancer spreading procedure. Why? Once the needle finds the tumor it pierces the shell the body's immune system has built up around the cancer cells. Withdrawing the needle, while squeezing the breast makes the cancer cells squirt into the breast tissue along the needle hole. More jabbing spreads the cancer cells around, and the capillaries in the breast pick up the cells and transport them throughout the body to lodge and replicate elsewhere - Isn't that special?

    Frank Weiwel, from People Against Cancer, tells me:

    Dr. Ian MacDonald, internationally known cancer surgeon, now deceased, presented extensive data on breast cancer in the American Journal of Surgery (March 1966) and concluded that "the massive educational, diagnostic and therapeutic attack on mammary carcinoma of the past two decades has failed to alter rates of incidence and mortality of this most frequent malignant neoplasm in female patients. Reports on the therapy of mammary cancer in the surgical literature often lack significance through selected samples of small size and the lack of statistical validation." When the statistical errors are accounted for, he added, the corrected data "lend little if any support to the case for 'early' diagnosis."

    In other words - it is common knowledge both inside and outside the cancer industry that the Oracs of the world represent the front line of deadly bullshit. And, they are on their way out.

    Orac woke up not so long ago, I think, and realized that he had the equivalent of "Exclusive manufacturing and distribution rights to DDT in the US" and that those people pounding on his door at 6:00AM were EPA Agents with a warrant to dig up his basement floor.

    Orac, I think, instead of changing his life, his career path, and finding a path towards "good," has decided to lash out at others - those that had taken the right path to start with. He turned vicious, and nasty, and because of that I think Quackbuster Central will use him to replace Stephen Barrett.

    The new guy heading up the quackbuster assault is going to be, I think, "Orac the Nipple Ripper."

    Moopheus wrote

    Perhaps they will try to keep adding data until they get data they like?

    That's a traditional procedure in parapsychological "research." It's called an optional stopping rule, meaning just what Moopheus described. Andreas Bachmair has adopted the deeply flawed methods of a good deal of old psi stuff.

    lieLady

    Kinda like payback for loading the dice, stacking the deck and contaminating the VAERS website.

    Science is about honesty. You're not very honest. Don't worry about me. It's you who is not honest

    By augustine (not verified) on 31 Aug 2011 #permalink

    Comment the first re Jen (the second is link-heavy and may be held up in moderation for a while)

    From Jen

    11:47 am

    But the CATS study ( THAT FUNNILY ENOUGH YOU NEVER BOTHERED TO ANALYZE) didn't backfire so spectacularly. You are cherry picking!

    12:21 pm

    so what other science blogger analyzed it??

    12:34 pm

    I asked what other science blogger analyzed the study.

    1:37 pm

    It just seems very lame that a science blog person such as Orac would go after a survey like this, but doesn't analyze something like the CATS study. Definitely cherry picking.

    My goodness, Jen is demanding.

    First,since Jen can't be bothered to cite the study correctly, I will do it for her: Hallmayer J et al. (2011)
    Genetic Heritability and Shared Environmental Factors Among Twin Pairs With Autism. Arch Gen Psychiatry. 2011 Jul 4. [Epub ahead of print] doi:10.1001/archgenpsychiatry.2011.76

    Second, as others have pointed out: Hallmayer et al. may have come to questionable conclusions, but the data-collection process was sound. What's laughable about the Bachmair "study" discussed here is that the process was fatally flawed...in a way that a high-school student, preparing for a science fair, should be able to detect.

    Third...well third will have to wait for my next comment which is link heavy and thus will have to wait to clear moderation.

    Well when "jen" was busy posting here about this study, she also made a foray back to the mother ship (AoA)and posted on today's article about the same study, entitled "Vax UnVax Study Results":

    "Of course, Orac was all hot and horny to write about the flaws in this survey, but didn't touch the CATS study. Cherry picking, I think he calls it."

    Posted by: Jen | August 31, 2011 at 12:25 PM

    Not a very ladylike comment, eh?

    Poor Jen is obviously confused as to the term cherry picking. No wonder it can't understand science. =(

    By Poodle Stomper (not verified) on 31 Aug 2011 #permalink

    In my previous comment I pointed out how demanding Jen was: show me the comments from science bloggers about Hallmayer (2011) et al.! You are being mean and unfair to Bachmair cause you all didn't criticize Hallmayer like this!!!

    So I went to look to see which "science bloggers" (to meet Jen's demand) had discussed Hallmayer (2011). This is what I found (this list isn't exhaustive and has some overlaps with previous links, above

    Neil Greenspan at the Evolution and Medicine Review
    John Wills Lloyd at EDB Blog
    Scott Bowen at Better Health Blogs
    Christopher Fisher at Behavioral Medicine Report
    Clara Lajonchere at Autism Speaks blog
    Virginia Hughes at VirginiaHughes.com
    Hannah Waters at Nature's A Spoon Full of Medicine
    Lisa Jo Rudy at Autism.About.com
    Virginia Hughes at Simons Foundation for Autism Research
    Kevin Mitchell, Wiring the Brain on Hallmayer et al. 2011

    This last blog post has some detailed and sophisticated analyses of some of the assumptions that Hallmayer et al. (2011) made to come to their conclusions, including the following observation:

    The methodology involves some statistical modeling that tries to tease out the sources of variance. However, this modeling is based completely on a multifactorial threshold model for the disorder - the idea that autism arises when the collective burden of individually minor genetic or environmental insults passes some putative threshold. Sounds plausible, but there is in fact no evidence - at all - that this model applies to autism. In fact, it seems most likely that autism really is an umbrella term for a collection of distinct genetic disorders caused by mutations in separate genes, but which happen to cause common phenotypes (or symptoms).

    An aside: Referring to Hallmayer et al. 2011 as "the CATS study" is likely to cause confusion later, as the California Autism Twin Study (CATS) is likely to generate more than one paper.

    The California Autism Twin Study (CATS) seeks to study the behavior and learning styles of children with autism and their twins. The study will enroll families with twins throughout California in order to learn whether some characteristics of autism, including impairments in social interaction, language and learning are shared between twins. By evaluating twins where one or both twins has autism, researchers hope to find out which characteristics of autism are influenced more by genes and which are caused more by something else. Scientists from Stanford University, Kaiser Permanente, University of California, San Francisco, Autism Genetic Resource Exchange (AGRE), the Medical Investigation of Neurodevelopmental Disorders Institute (M.I.N.D), and California CADDRE are collaborating on this study. The study is being funded by the National Institute of Mental Health (NIMH).

    Now, back to discussion the weaknesses and foibles of the Bachmair "study".

    Jen amuses me.

    Maybeâjust maybeâif I'm feeling in a particularly cussed mood, I'll review the CATS paper sometime in the next few days just to amuse myself and shut up annoying trolls like Jen who seem to think that I'm somehow afraid of it.

    Or maybe not. I hate to reward bad behavior overmuch.

    I also hate to waste a post on it just to prove to someone like Jen that its results don't somehow strike fear into my blogger's heart. Also, the study is old news as far as I'm concerned, and others have already handled it quite well.

    Stay tuned.

    Call me Pollyanna, but I just like to think of you as having an open mind.

    @ Tod W.

    Thanks for clearing up the confusion; the sham acupuncture was never explained to me very well. I'm a relatively new reader, and I've been trying to remove the years of misinformation my relatives and former teachers have pounded into my head.

    @ Rogo5: "I've been trying to remove the years of misinformation my relatives and former teachers have pounded into my head"

    Oh, say it isn't so, Rogo! That's terrible- especially the "former teachers" part... what *kind* of teachers were they, pray tell? Not very good ones, I would guess.

    Whether it was luck or through my own successful machinations, I managed to acquire truly great teachers, profs, and a mentor who put me on the right path.( Parents were realistic as well)

    Stick with us, Dude ( or Dudette!) The real world is a lot more intriguing than any fictions half-baked mystics and opportunistic woo-meisters can dream up in order to sell products, ideas, or themselves. And we can understand it in all its fascinating complexity! Woo Hoo.

    By Denice Walter (not verified) on 31 Aug 2011 #permalink

    Funny that I miss all of jen's whining and the trolls usual brain-dead crap that they usually post.

    Made for some amusing reading for laughs.

    There is absolutely no recognized medical specialty known as "surgical oncologist."

    Actually, that's simply not true. There is a recognized surgical specialty known as surgical oncology:

    http://www.surgonc.org
    http://www.surgonc.org/training--education/surgical-oncology-fellowship…

    In fact, Surgical Oncology was recently elevated to one of the specialties for which there will be Board Certification.

    There are also breast surgery fellowships, making breast surgery a recognized specialty:

    http://www.surgonc.org/training--education/breast-oncology-fellowships…

    The "Gold Standard" of breast cancer surgery is called the Halstead Procedure, which, in reality, draws a surgical line four inches above the naval, and a second line just below the collar bone. Everything between the lines is chopped off - down to the ribs, including all those 29 lymph nodes. "Mom" comes home from the hospital looking a lot different. Then, since all those lymph nodes are gone her arms are going to swell up to the size of her waist.

    What is this? 1950? Or 1966, which is the most recent medical literature you appear able to cite? The Halsted radical mastectomy hasn't been the standard of care for breast cancer for at least thirty years. In fact, I've never done one; I've never even seen one done. You see, by the time I did my residency in the late 1980s, the Halsted radical mastectomy had long ago been replaced by less invasive procedures, such as lumpectomy and axillary dissection or the modified radical mastectomy, which preserved the underlying muscle. These days, only about 25% of women with breast cancer require mastectomy; most can have breast-sparing surgery. Most don't require the removal of all their lymph nodes any more.

    Do try to use evidence and practices from this century.

    But, thank God, all this is on the way out. City Cemeteries won't be doing a boom business in "Mom we love you..." signage so much, now that the government, and hence insurance companies, have cut out those "annual mammograms" designed to scare young women into letting some ghoul stick needles into her breasts for so-called tests.

    See:

    http://scienceblogs.com/insolence/2009/11/really_rethinking_breast_canc…

    http://scienceblogs.com/insolence/2009/12/how_not_to_protect_your_medic…

    One also notices that ChildHealthSafety has made an appearance. One also notices that CHS chooses to focus obsessively on a rather minor point, the whole 20% thing, and ignores the major criticisms, namely no control group, selection bias, recall bias, no control whatsoever for confounding factors (particularly different health care-seeking behavior), and, of course, the fact that this is nothing more than an Internet poll of the sort that PZ Myers over at Pharyngula routinely sends his minions over to crash.

    I didn't do that because I didn't want to give our friendly neighborhood German homeopath an "out." His survey was badly designed enough, and his results, for autism at least, are completely within the range of error of estimates for autism prevalence. In brief, I was too amused by the fact that this "study" actually comes far closer to refuting the vaccine/autism hypothesis than providing evidence to support it. Of course, as I said before, the survey is so bad that it really doesn't tell us much of anything, but CHS is too scientifically ignorant to realize that.

    a surgical line four inches above the naval
    The naval what

    By herr doktor bimler (not verified) on 31 Aug 2011 #permalink

    Feck.
    The navel what? Dude, you seem to be confusing surgery with the Plimsoll line.

    By herr doktor bimler (not verified) on 31 Aug 2011 #permalink

    "But at the same time ignores that in the 15-16 year age group the figure is 0.62%."

    So? If you don't understand why this is meaningless, maybe you should check your source site. They understand better than you (or are not as dishonest)

    This is from that site. In bold no less:

    "Note also, that the groups 9-10 years, 11-12 years, 13-14 years, 15-16 years, 17-18 years are very small and the results in these subgroups are not significant."

    There was 1 kid in 160 in that age group. I'd ask if this is sufficient for you, but your standards are so low that I know the answer.

    By Cliff Stone (not verified) on 31 Aug 2011 #permalink

    "that it really doesn't tell us much of anything, but CHS is too scientifically ignorant to realize that."

    Given their track record "ignorant" is being polite.

    By Cliff Stone (not verified) on 31 Aug 2011 #permalink

    Oh cripes, Bolen is baaaaack. Tim, that cut and paste job from your website had no meaning back then (November, 2009) and has even less meaning now.

    @ Denice Walter

    You guessed correctly, my former teachers weren't the greatest. And, out of all things, they had a master's degree in biology and chemistry! While they didn't promote the woo, they remained neutral and considered the "plausibility" of acupuncture and other forms of alternative medicine. It's really not surprising, considering my small hometown has six different chiropractic clinics and nine naturopathic/herbal dispensaries. (I mean, it's really disgusting how many people believe in the urban myths and pseudoscience around here!) I didn't see the extent of the horrible quackery until I found out what the real definition of homeopathy was. (Beforehand, I thought "homeopathic medicine" was another synonym for "natural" or "herbal" medicine like so many people). And yes, I do plan to stick around for quite a long time. :)

    ORAC claims

    "63 ..... this is nothing more than an Internet poll of the sort that PZ Myers over at Pharyngula routinely sends his minions over to crash. ..... I didn't do that because I didn't want to give our friendly neighborhood German homeopath an "out."

    Posted by: Orac | September 1, 2011 12:01 AM

    Really? How more plainly dishonest can it get. You added a postcript to your blog noting this new survey is still open for comments, clearly to invite your minions to sabotage it. What a low-life.

    And what did they start doing? Yep sabotaging it:-

    "13 The survey does indeed appear to still be ongoing .....

    Kind of tempting to mess with their results...

    Posted by: Ash | August 31, 2011 11:15 AM"

    And:-

    37 Well the "open" survey now has 7,799 participants...I think the 7,799th "child" might be "mine". I filled out the survey on behalf of my six year old...who is unvaccinated and has 10 siblings. I entered "yes" to every question about disturbed sleep, fussiness, medical issues and developmental diagnoses.

    I haven't had so much fun messing up a "survey" since I responded to a robocall from the Tea Party Voter Choice Telephone Survey.

    Posted by: lilady | August 31, 2011 4:04 PM

    Thanks for the open demonstration of low-life from Orac and friends.

    From the survey:

    Why is your child not vaccinated?
    Vaccine damage/reaction of siblings and friends
    Intensive preoccupation with vaccine topic
    Conviction of ineffectiveness of vaccines
    Through fear of side effects
    Due to preexisting conditions of the child
    Concerns about ingredients in vaccines
    Religious/philosophical belief
    Other

    Is it me, or is this a little 'stacked' towards the main anti-vax arguments? I find the language quite emotive and leading.
    How do people, who admit to (probably) not seeing doctors, know if there is any preexisting conditions of the child? If a mother of a 6 mo old unvaxed child has been exclusively breast-feeding, how does she know if it has an egg-protein allergy? Like Orac points out: a lot of these children could have subclinical or mildly clinical disease that goes undiagnosed because of lack of proper medical attention. On the other hand, the family chiropractor/naturopath/iridologist/palm reader could have diagnosed conditions in the child that do not actually exist.
    And what does "Intensive preoccupation with vaccine topic" even mean?

    Tim @ 49

    Wow, that wins the "Most Vitriolic Ad Hominem" of the week award. Good on you for adding nothing to the discussion at hand!!!

    T0 Orac who said September 1, 2011 12:01 AM

    63 One also notices that ChildHealthSafety has made an appearance. One also notices that CHS chooses to focus obsessively on a rather minor point, the whole 20% thing

    On the contrary, catching you out on your own junk science and mathematically challenged thinking is no small thing when that is what you spend your time trying to attack others over - when you are not busy alternating to insulting and abusing them on your blog.

    And we caught you also on claiming the children in the studies might have these conditions but no one knows because they have no symptoms. That is a real whack-job.

    And then we caught you out on the one side saying the study tells us nothing and then claiming it is clear evidence vaccines do not cause autistic conditions.

    Face it Orac, you have been caught out fair and square as being unscientific, lacking analytical and mathematical skills. And this is at the same time as abusing and denigrating others claiming the very same sins against them.

    Loser.

    And we caught you also on claiming the children in the studies might have these conditions but no one knows because they have no symptoms. That is a real whack-job.

    Allergies are a condition that you can be completely unaware of without because the symptoms only manifest when you are exposed to the allergen. So no you didn't catch anyone but just ended up showing how stupid you are.

    I believe CHS's only point here was to be able to say 'ha ha' and report back that he did so. Rational, sane debate was never in the cards. Certainly reality never enters into any of CHS's ranting.

    Yes, I entered data on the open survey from my one computer site and it is probably just a valid as the data from the other "participants"... and might even be "more valid".

    When you have an open internet survey with ambiguous wording anyone can "wander" over and enter data to skew the results. Now I am not accusing anyone at ChildHealthSafety for deliberately putting a bogus survey up on the internet to encourage multiple false entries and I'm not stating that the design deliberately did not meet any of the criteria for a survey...but it is less valid than the Tea Party Telephone Survey that I participated in several weeks ago...which really was a robo call randomized survey.

    The folks at ChildHealthSafety have no way of knowing what percentage of the participants really have a child...no less a vaccinated or unvaccinated child and no way of knowing if any, some...or most of the participants are childless paranoid cranks who are against big government and/ or Big Pharma. Indeed, perhaps some of the participants are manipulating the publicly held stock of vaccine manufacturers.

    Now I'm no computer techie, but I know enough about entering data on a public site requires you to provide a valid email address...which I did not...and surprise, surprise!!!...the data was accepted.

    Yes indeed, the data I entered was probably just as valid as the data entered by the other "participants".

    So here's the deal, unlike other participants I publicly stated that I entered data which was false and easily "verifiable" as false by the "researchers" by simply contacting the invalid email addresses.

    Imogen: "Is it me, or is this a little 'stacked' towards the main anti-vax arguments? I find the language quite emotive and leading."

    No. It's not you. That set of options is stacked. The language is indeed leading, which leads me to suspect that the 'survey' is not likely to be valid at all. I think Elizabeth Loftus' old research pals would be very interested in the way in which fringe groups of fuckwits use language in order to lead the thinking of others in directions like this.

    Bullshit survey. That is all.

    By David N. Andre… (not verified) on 01 Sep 2011 #permalink

    To: Adam_Y who said September 1, 2011 9:33 AM

    74 Allergies are a condition that you can be completely unaware of without because the symptoms only manifest when you are exposed to the allergen. So no you didn't catch anyone but just ended up showing how stupid you are.

    Adam, it is always wise to read the question before writing an answer. That is exactly what Orac was not saying. He was saying:-

    "a lot of these children could have subclinical or mildly clinical disease that goes undiagnosed"

    "One of the most common presentations of asthma is cough alone" .... "milder cases of asthma can be difficult to diagnose in children".

    So that is
    1) no symptoms whatsoever - subclinical - whether exposed or not;
    2) such mild symptoms that whatever the allergy it is just not a problem, exposed or not.
    And if a case is subclinical or mild then that ipso facto means exposed and not unexposed, otherwise you would not know if the case presentation was subclinical, mild, moderate or severe.

    So who is stupid, stupid? Looks like it is not just Orac who has had an analytical skills total bypass from birth.

    You lot seem to be amateur hour skeptic clones incapable of independent rational thought - just an insatiable appetite for abuse bullying and ridiculing others.

    But thanks for the abuse, it all adds to the picture of bullying and abuse Orac and his self admitted "minions" paint.

    To lilady who said September 1, 2011 9:42 AM

    "76 Yes, I entered data on the open survey from my one computer site and it is probably just a valid as the data from the other "participants"... and might even be "more valid".

    Now I'm no computer techie, ....."

    You do not need to be to know that the next thing "lilady" says is bunk, just a tiny smattering of common sense will do it.

    She says

    "but I know enough about entering data on a public site requires you to provide a valid email address...which I did not...and surprise, surprise!!!...the data was accepted."

    Really? How do you know. As you did not enter a valid email address you could get no acknowledging email nor any queries about your entry. And you also do not know if the data was actually "accepted" as valid for the survey. It is common for surveys to use analytical techniques to weed out seemingly junk responses - albeit presumably not perfect ones.

    " ..... unlike other participants I publicly stated that I entered data which was false and easily "verifiable" as false by the "researchers" by simply contacting the invalid email addresses."

    Complete nutter. 1) "publicly stated" - yep over here in Orac's blog but how would the compiler of the survey be notified? 2) they may have contacted the invalid email address but you would not know whether they had nor not.

    Absolutely barmy. Another clone with an analytical skills total bypass from birth.

    Really? How more plainly dishonest can it get. You added a postcript to your blog noting this new survey is still open for comments, clearly to invite your minions to sabotage it. What a low-life.

    And what did they start doing? Yep sabotaging it:

    How much more plainly dishonest can it get? Trying to pretend a poll like that is a source of scientific data in the first place, that's how. The difference between you and us is that to us, that poll is bad no matter what the apparent results are, because no attempt has been made to eliminate even deliberate biasing, let alone any of the many other kinds. To you it only became bad once it was exposed as blatantly vulnerable to any kind of manipulation and lost its value as a propaganda tool.

    It's as if you went walking around town, demanding to be treated with the utmost deference because you were rich, a claim that you brandished a fat roll of $50s to back up. Then we came along with a counterfeit detector pen that put black stripes on all those bills and revealed that they were fakes run off on a color copier. You may act outraged and scream about how much money we took from your pocket, but the fact is that we didn't take away a single thing that you actually had.

    By Antaeus Feldspar (not verified) on 01 Sep 2011 #permalink

    @ David N. Andrews, M. Ed., C.P.S.E.

    David, you certainly have a way with words
    ( and probably have your way with everything else!) Ha ha.

    By Denice Walter (not verified) on 01 Sep 2011 #permalink

    To Antaeus Feldspar's comment of September 1, 2011 10:52 AM

    From his page on Wikipedia - all anyone needs to know:

    "I am proud to be the recipient of a WikiMedal for Janitorial Services, awarded by Topbanana.

    WikiMedal for Janitorial Services, awarded by Topbanana

    I have been accused of being a "cult PR agent" by anti-cult activists and an anti-cult fanatic by cult supporters. I must be doing something right. Strange; one might conclude that I must enjoy working on cult articles, but such is not the case..."

    Awarded by Topbanana. Ha. Nuff said.

    But err ..... Wikipedia? Hmmmm. That is the website encyclopedia full of errors and one sided points of view, edited by 9 year olds and others who seemingly spend their lives on it.

    Oh, and thanks for the abuse and personal attacks. Much appreciated. It all adds up.

    Lielady: nice try at justifying yourself. You have way too much free time on your hands. Why not volunteer somewhere, instead of obsessively dredging up other people's comments, crashing surveys etc.?

    Given that vaccine-preventable diseases can KILL people, her actions may just save somebody's life.

    By Gray Falcon (not verified) on 01 Sep 2011 #permalink

    Ignore the willfully ignorant troll.

    Why "jen", do you keep posting here? After all it is site for science-based medicine...about which you are clueless.

    Yes, I did have to "dredge up" your comments...through the pseudoscience muck of your mother ship. Uncomfortable with your actual postings? Tough.

    And guess what jen I do "volunteer" after years of working in the public health field and years of advocacy on behalf of disabled kids...including children with autism. Indeed, you and your "pals" have all benefited by my advocacy work.

    Really? How more plainly dishonest can it get. You added a postcript to your blog noting this new survey is still open for comments, clearly to invite your minions to sabotage it.

    Uh, no. I meant what I said. I don't encourage or condone crashing this particular survey because I think it serves my purpose far better to let it go as is and not to give anti-vaxers an "out" to claim that I somehow tried to corrupt their survey. Believe me, if I thought it would serve my purpose to try to mess up the survey from without, I would have included in my post an explicit request for my readers to crash the survey, and I probably would have e-mailed PZ Myers to see if he'd bring his considerably greater blog firepower to bear on the hapless homeopath. I didn't, and I encourage my readers not to mess with this poll.

    I think the survey "researchers" have a lot more than me to worry about. The internet survey has been visited by other skeptics who have also entered false data. That's what happens when you "attempt" a "scientific" survey on the internet and notorious anti-vax bloggers provide links to the "open internet survey".

    A vaccinated versus non-vaccinated survey is unethical and this internet survey is unethical as well.

    Lielady [HAR! HAR!]: nice try at justifying yourself. You have way too much free time on your hands. Why not volunteer somewhere, instead of obsessively dredging up other people's comments, crashing surveys etc.?

    Jen, you could always do the same rather than repeatedly popping up here to make a fool of yourself.

    Ahhh, Child Health Safety, who claims that supporting the use of the measles vaccine makes you a racist. Fun, fun, fun.

    By Matthew Cline (not verified) on 01 Sep 2011 #permalink

    Matthew Cline:

    Ahhh, Child Health Safety, who claims that supporting the use of the measles vaccine makes you a racist. Fun, fun, fun.

    And absolutely refused to answer my very simple question why the incidence/morbidity of measles in 1970 was only 10% of the 1960 level in the USA. Despite being shown the census data several times. All he gave was one incoherent dodge after another.

    It seems that he ignores history and science, just like he ignores basic rhetoric.

    And it does not seem to occur to him that internet surveys of any kind have no scientific legitimacy. They are self-selected, so are the most unbiased form of data. Plus, and he seems to have missed the first comment on this thread, there is no way to verify the children are actually real. Email verification is not sufficient, even if it is a real email address.

    The information from this survey is completely worthless.

    (note: I have not posted any children real or fictional on that survey)

    Ah, yes, the "you edited at Wikipedia years ago so somehow that refutes whatever you have to say now" argument. How boring. How unoriginal. How irrelevant. If you actually believed that treating the results of a trivially manipulated Internet poll as scientific data was defensible, you would have put forth a defense. Instead you engage in ad hominem attacks and then turn on a dime to whine about "abuse and personal attacks" that no one made except you.

    By Antaeus Feldspar (not verified) on 01 Sep 2011 #permalink

    How utterly idiotic. Anybody who bothered to consult a real statistician, or even crack a statistics text, would have realized that you can't do a valid survey in this manner. Let's count the errors, any one of which is sufficient to completely invalidate any conclusions that might be drawn from the results.

    1. Biased self-selection of participants. A web site entitled "Vaccine Injury" is obviously going to attract individuals who are biased toward the belief that vaccines cause harm and thus less likely to admit that their children suffer illnesses that they blame on vaccination. After all, a parents who avoids vaccination are placing his/her child at increased risk of diseases that can cause death or brain damage--they are going to be highly disposed to believe that the risk is justified, whether it is or not.

    2. No independent assessment. The problem of bias extends to the assessment of child health. It is now well-established that differences in the type of medical treatments that people receive may be correlated with differences in the type of medical care and surveillance that they experience, and that such differences can produce highly misleading conclusions. For example, early studies of women who were receiving elective hormone replacement therapy (HRT) reported cardioprotection, but randomized placebo controlled studies found the reverse, because while HRT itself increases the risk of cardiovascular events, receiving HRT as elective care was associated with better overall medical care, which masked the detrimental effect of HRT. Orac has mentioned some ways in which this could bias detection of medical problems such as asthma that can easily go undiagnosed, but it is impossible to anticipate all such biases. The only way around it would be to have assessment by independent physicians.

    3. No verification. There is no verification of the accuracy of entries. Even if valid email addresses were required (and it is easy to create "valid" email addresses under fake names), people can lie from a valid address (it's not illegal to do so.)

    4. No control group. Estimates of the incidence of autism vary greatly from study to study, so it is impossible to make a meaningful comparison to "historical controls." There are also no standardized methods of assessing severity of autism. Having a control group that receives the same assessment (done "blinded") is thus essential for any kind of validity (see #2).

    5. No measure of response rate. What fraction of the target population even saw the survey, and what fraction of them chose to answer it? This is essential to judge the potential magnitude of bias effects, although from general principles we can judge the potential impact of bias as "huge" (see #1).

    In other words, this is a stupid way to do such a study, and any results are utterly meaningless, as amusing as it might be to point out (as Orac has such fun doing) that the results don't even agree with the claimed conclusions.

    "Oh, and thanks for the abuse and personal attacks. Much appreciated. It all adds up."

    Right. When CHS heaps abuse and personal attacks it doesn't mean anything though.

    The "ChildHealthSafety" blog is run by people with very low standards of ethics. Whether this is why they appear to not understand rudimentary science or whether they sincerely misunderstand is another thing. Their support for Andy Wakefield is nothing short of amazing. It's one thing for Andy to spread misinformation, but quite another for someone else to take up the charge. Wakefield lies to cover his own. Why are "ChildHealthSafety" putting out blatant and easily falsified misinformation? It astounds the well informed reader. Not in the good way, mind you.

    By Cliff Stone (not verified) on 01 Sep 2011 #permalink

    jen, augstine, Tim Bolen and the Child Health Safety folks are on this thread?

    I'm not sure this website can handle the misinformation that is upon us. For the love of all things holy, please don't let JB Handley or Jake Crosby on - because if you think circuits are frying now....

    Absolutely hilarious. Recent posts way off topic.

    The one about measles and nazis and accusations of "refusing to answer questions" is priceless.

    Love it - "We haf ways of making you talk"!!

    And delightful on the abuse front. Here you folks slap it around like there was no tomorrow but don't like it when you get the same treatment. Fabulous.

    Mad Hatters tea party. Taking a smidge too much thimerosol in your coffee peut-être?

    you edited at Wikipedia years ago so somehow that refutes whatever you have to say now

    Is there some word for this combination of non sequitur and ad hominem?

    By herr doktor bimler (not verified) on 01 Sep 2011 #permalink

    You have way too much free time on your hands. Why not volunteer somewhere

    Earlier in the thread I was annoyed with Jen for insistently wanting other people to direct her to science bloggers' analyses of the CATS paper; and for doubting that such analyses existed (not even Sullivan's scrupulous examination of the study's strengths and weaknesses, on which Jen herself had been commenting a few weeks earlier).

    Now I realise that her time is spent volunteering somewhere and I can forgive those demands.

    By herr doktor bimler (not verified) on 01 Sep 2011 #permalink

    "Here you folks slap it around like there was no tomorrow but don't like it when you get the same treatment. Fabulous."

    It's not that the people here don't like the treatment (we're used to it round here), it's that you're giving out and giving out (without reasonable provocation) and then whining like a little wuss when people start treating you in kind as if you're somehow a special snowflake who isn't allowed to be criticised.

    You are persistantly offensive and abusive. It's high time you shut up about how you get treated if you can't keep your mouth in check.

    The abusive language starts with your post @33. If you think you're responding to abuse rather than the instigator of it, then quote from an earlier post or shut and sit back down.

    Pretending you're a victim responding in kind rather than an abuser doesn't wash here as anyone can see how you've behaved very clearly.

    Deal with what people are saying to you or kindly stop wasting everyones time like you did over at lb/rb with your hilariously inept and counter-factual antics.

    And delightful on the abuse front. Here you folks slap it around like there was no tomorrow but don't like it when you get the same treatment. Fabulous.

    Funny, I don't remember dismissing any of your arguments by pointing to a hobby you gave up four years ago and asserting "this is all you need to know." Heck, I didn't even point out that on your blog you still have articles up falsely claiming Brian Deer to be the complainant in Andrew Wakefield's GMC case, which he is not any more than you by publicly defending Wakefield have become Wakefield's public defender. I could have brought that up and said "See? That's all you need to know about ChildHealthSafety, that he values propaganda value more than truth!" But I didn't need to, because the case at hand shows you complaining about the "sabotage" of "scientific data" that actually never had value as scientific data, only as propaganda, and it is that irrational position which is under criticism, not whether the person who holds that opinion or presents it was wrong about other things, has weird hobbies, etc.

    I dare you to stick to the topic in your reply. I dare you to try and defend the ridiculous proposition that an Internet poll of this nature with no safeguards against even the most blatant, deliberate tampering could ever qualify as scientific data. I'll bet, though, that you won't dare try.

    By Antaeus Feldspar (not verified) on 01 Sep 2011 #permalink

    I see the trolls have been busy whilst I have been without power and internet service for seven hours. Well I am back now and what's the BFD?

    I'm not sneaky like some people at notorious internet sites who set their mangy dogs on people who blog to have them lose their livelihood and I don't take orders from Orac...so stop with the smear tactics. I'm a big girl and quite able to handle any and all of your comments.

    And, guess what I would do it again, whenever a silly open internet survey is open for comments.

    You notorious anti-vaxers need to get an education, be able to discern what is science and what is pseudoscience, deal with the realities of what autism is all about, take care of your disabled kids...if you in fact have children who are disabled, stop wasting taxpayer money or yet another scientific study...in short, get a life. And, no you are no longer in the driver's seat...you no longer have any credibility and science has prevailed.

    CHS:

    The one about measles and nazis and accusations of "refusing to answer questions" is priceless.

    So, exactly was the incidence/morbidity of measles in 1970 only 10% of the levels in 1960 in the USA? What happened to bring down the numbers so dramatically? And please only answer about that decade.

    From http://www.census.gov/prod/99pubs/99statab/sec31.pdf
    Year.... Rate per 100000 of measles
    1912 . . . 310.0
    1920 . . . 480.5
    1925 . . . 194.3
    1930 . . . 340.8
    1935 . . . 584.6
    1940 . . . 220.7
    1945 . . . 110.2
    1950 . . . 210.1
    1955 . . . 337.9
    1960 . . . 245.4
    1965 . . . 135.1
    1970 . . . . 23.2
    1975 . . . . 11.3
    1980 . . . . . 5.9
    1985 . . . . . 1.2
    1990 . . . . .11.2
    1991 . . . . . .3.8
    1992 . . . . . .0.9
    1993 . . . . . .0.1
    1994 . . . . . .0.4
    1995 . . . . . .0.1
    1996 . . . . . .0.2
    1997 . . . . . . 0.1

    Oops, dropped a word, the question for CHS is "So, exactly was was the incidence/morbidity of measles in 1970 only 10% of the levels in 1960 in the USA?"

    Lielady

    You notorious anti-vaxers need to get an education, be able to discern what is science and what is pseudoscience...

    Lieliady, you need to get an education and some culture. Are you going to DragonCon this weekend? You're not a "real" science blogger until you've been. You might want to recheck your street cred.

    By augustine (not verified) on 01 Sep 2011 #permalink

    @ChildHealthSafety

    Why do you hurl invectives rather than addressing the actual flaws in your survey? trrll did quite a good job of explaining the major ones. In fact, the flaws are so obvious that even non-scientists could spot them.

    If you really feel that your survey was of sound design and rigorous quality, why not submit it for peer review and publication in an actual journal, rather than posting it online?

    Some other questions occur to me regarding the survey. There is no clear statement of who is the sponsor. While the imfschaden and vaccineinjury web sites are listed as the ones conducting the survey, this is not clear enough to determine whether they are the sponsors or merely just administering the survey. Without knowing this information, we cannot conclude whether they are subject to OHRP regulations governing the protection of human subjects in research (45 CFR 46).

    This is an important question, since the survey collects data that could lead to identification of the subjects (e.g., e-mail of responder; initials, birth date, age, gender and country of the child) and the responses could have a detrimental effect on the respondents' "financial standing, employability, or reputation," it may require ethical review by an Institutional Review Board. In fact, since the survey involves children, that exemption does not apply, and the survey, if covered by OHRP regulations, would definitely require IRB review.

    Speaking of which, there is no mention, at all, of IRB review/approval, which suggests that no independent ethics board looked at the survey protocol and questions to determine if they were appropriate to administer to people.

    In short, in addition to the methodological flaws with the study, there might also be ethical/legal violations.

    Still ignoring ignorant, lying, filthy-mouthed troll. Maybe Thingy will "terminally disinfect" troll.

    Chris [Christen?] @ September 1, 2011 7:55 PM

    Your question is already answered on the CHS article you write about and has been for a long time. Basic exam technique - read the question before answering it.

    _____________

    Todd W. @ September 1, 2011 9:52 PM

    "Why do you hurl invectives rather than addressing the actual flaws in your survey?"

    As for not answering. Looks like you have not been paying enough attention over at CHS.

    As for "invective" - not our usual approach. Just doing it for all you guys. Giving you a taste of your own medicine. Looks like you don't like it. But you sure deserve it.

    _____________

    Antaeus Feldspar @ September 1, 2011 5:33 PM

    "I dare you to stick to the topic in your reply."

    We are but no one else here seems to be, as already noted in a previous comment of ours.

    "I dare you to try and defend the ridiculous proposition that an Internet poll of this nature .... could ever qualify as scientific data."

    You are the one putting that proposition. So creating a strawman. Its a survey. You can't read can you.

    _____________

    Just reviewing the comments here. Looks like you guys are not doing so well on your own territory. What with Orac shown up as analytically and mathematically challenged and the rest. Then others of you shown up too. Not a good score for losers.

    CHS, you sound like our resident delusional troll by simply declaring victory for some imaginary fight. I have not read anything substantive by you with regards to this survey. Would you care to offer any reasons why this survey is valid? Do you see any weaknesses with this survey that are concerning?

    @ChildHealthSafety

    Why would I wander over to your site when the discussion I'm referring to is happening here? I will give you points for dodging the meat of my post, though. Seriously, how do you justify holding this survey out as sound science when it is so flawed? What do you say about trrll's points?

    Again, you are focusing on the unimportant bits of people's posts and avoiding the serious questions.

    "Chris [Christen?] @ September 1, 2011 7:55 PM

    Your question is already answered on the CHS article you write about and has been for a long time. Basic exam technique - read the question before answering it."

    Then give a reference. Article, page, paragraph, time last accessed, just like you had to at college/uni.

    Also, the second half of you comment makes no sense. You're criticising someone for not reading an answer you did not provide a reference for - even though this person could easily have found the purported answer insufficient thusly 'you didn't read it' is not an answer - but then go on to talk about exam technique of reading the question.

    If you can't tell the difference between an answer and a question then there is little that can be done to help you.

    "Giving you a taste of your own medicine."

    Prove it. The earliest offensive and derogatory language in this thread is yours by a country mile. This fits in with your known previous behaviour of acting like a total prick and then blaming it all on others when they respond in kind.

    In order for your behaviour to be caused by others you would need a fucking time machine.

    You are the one responsible for your own behaviour. Time for you to grow up and admit to it. Get some serious help.

    To Dedj @ September 2, 2011 7:39 AM

    Who says:-

    "The earliest offensive and derogatory language in this thread is yours by a country mile." And then says "acting like a total prick" .... "In order for your behaviour to be caused by others you would need a fucking time machine." ... "grow up" .... "Get some serious help."

    LOL.

    So just jumping in the "fucking time machine" to Orac's comments on this very article [and there is lots more in others' comments here]. The lovely cuddly David says LOL:

    "a study that's just so mind-numbingly, brain-meltingly awful"

    "the sheer intensity of its burning stupid"

    "a starving cheetah ripping into its prey look downright restrained"

    "anti-vaccine loons" "anti-vaxers"

    ".... they've been clamoring for what they like to call a "vaxed-unvaxed study."

    "Now they're at it again"

    "anti-vaccine propaganda"

    "now this "study" will no doubt join the Generation Rescue "study" in the annals of crap vaccine/autism science, to circulate around Whale.to (where it belongs) and be dredged up as "evidence" periodically."

    And Chris/Christen's other question has been answered in spades the total loser should go and read the CHS article. [Abuse added for effect only. The people who habitually read Orac's drivel use it all the time and don't appear to understand anything else, as Dedj demonstrates, so not much other option for communication on this blog].

    CHS reminds me of a friend I had when I was young who, when playing the board game Monopoly, would flip the board over if he was losing and declare that he would have won if we had finished. Same delusional, juvenile response.

    One last shot for sanity from CHS:
    The study was/is based on a survey administered on the internet. How is that even remotely, scientifically sound?

    "Anyways, back on topic, does it seem like they are keeping the survey open so that they can get the results that they want? Seems like that to me"

    If they didn't have the results they wanted, they wouldn't have posted the data at all. What an absurd notion.

    @ Chris - that is clearly incidence data, not morbidity data. Please provide ANOTHER list that only shows morbidity rates from 1850 ~ 1970 for measles and then we can compare 1960 to 1970 by year.

    Of the 109 incidences of measles reported in the US so far where vaccination status was known, 21% had between 1~3 MMR jabs and there were no deaths reported. That's what we know for 2011 so far. (CDC)

    @Coulter

    Meaning the majority had inadequate protection against measles (no shots or only one shot). While there have, as yet, been no deaths reported, a 12-month old child in MN was, as of last reports, still in critical condition. One other child infected by the 12-month old was also hospitalized, but recovered and was released. Also in MN, the previous outbreak (also this year, consisting of 21 cases, only 1 of which was fully vaccinated) resulted in 14 hospitalizations. A final thing to note is that every one of the outbreaks we've seen in the U.S. this year has been a result of an unvaccinated index case.

    Also, it seems you might have meant "mortality" instead of "morbidity," since morbidity is incidence rate of a disease. It is true that mortality rates decreased before introduction of the measles vaccine, but all that means is that we were better at keeping people alive, though many still suffered complications from the disease (encephalitis, blindness, deafness, etc.), not to mention being at risk of death months or years after recovery due to SSPE. The numbers Chris provided show how effective the MMR has been at preventing new cases of measles.

    @ Coulter: I believe you are mistaken about the 109 cases reported in the USA so far....

    MMWR May 27, January-May 20, 2011

    Unvaccinated persons accounted for 105 (89%) of the 118 cases. Among the 45 U.S. residents aged 12 monthsâ19 years who acquired measles, 39 (87%) were unvaccinated, including 24 whose parents claimed a religious or personal exemption and eight who missed opportunities for vaccination. Among the 42 U.S. residents aged â¥20 years who acquired measles, 35 (83%) were unvaccinated, including six who declined vaccination because of philosophical objections to vaccination. Of the 33 U.S. residents who were vaccine-eligible and had traveled abroad, 30 were unvaccinated and one had received only 1 of the 2 recommended doses.

    The complete article is at the MMWR website (May 27, 2011 issue)

    I don't see anything about anyone who received "3 jabs" of the vaccine...quite to the contrary it was those who were unvaccinated who brought the disease back from abroad. The rest of the article in exquisite detail, shows the value of timely immunization and completion of the 2-dose series for prevention and containment of measles.

    Oops, just to clarify my post above:

    Data is from the MMWR Issue, dated May 27, 2011

    The Article in the MMWR is entitled:

    Measles....United States January-May 20, 2011

    Hi lilady,
    I do not believe I am mistaken.
    http://www.bt.cdc.gov/HAN/han00323.asp

    Of the 139 case-patients who were U.S. residents, 86 (62%) were unvaccinated, 30 (22%) had undocumented vaccination status, 11 (8%) had received 1 dose of measles-mumps-rubella (MMR) vaccine, 11 (8%) had received 2 doses, and 1 (1%) had received 3 (documented) doses.

    139 - 30 = 109 case-patients were vaccination status was known. 11 + 11 + 1 = 23 (21%) who had between 1~3 documented MMR jabs.

    Well as someone at AoA said, which Lilady would have looked up anyways, this data is just as reliable as the VAERS data. Just as reliable as the VAERS data. How is the VAERS system scientifically sound?

    @ Todd W.

    "It is true that mortality rates decreased before introduction of the measles vaccine, but all that means is that we were better at keeping people alive"

    I thought it also meant that we were more healthy (and had better immune systems) thanks to better nutrition and sanitation, as well as learning more about treating said disease. I didn't realize it was ONLY because we got better at keeping people alive.

    "though many still suffered complications from the disease (encephalitis"

    Isn't that also a condition some may suffer from complications from the vaccine as well?

    269 events of encephalitis reported to VAERS following MMR (or similar) post-vaccination.

    From HAN (Health Advisory Network)

    This is an official
    CDC HEALTH ADVISORY
    Distributed via Health Alert Network
    June 22, 2011, 16 :00 EST (04:00 PM EST)
    CDCHAN-00323-11-06-22-ADV-N

    High Number of Reported Measles Cases in the U.S. in 2011âLinked to Outbreaks Abroad

    Summary and Background

    The United States is experiencing a high number of reported measles cases in 2011, many of which were acquired during international travel. From January 1 through June 17 this year, 156 confirmed cases of measles were reported to CDC. This is the highest reported number since 1996. Most cases (136) were associated with importations from measles-endemic countries or countries where large outbreaks are occurring. The imported cases involved unvaccinated U.S. residents who recently traveled abroad, unvaccinated visitors to the United States, and people linked to these imported cases. To date, 12 outbreaks (3 or more linked cases) have occurred, accounting for 47% of the 156 cases. Of the total case-patients, 133 (85%) were unvaccinated or had undocumented vaccination status. Of the 139 case-patients who were U.S. residents, 86 (62%) were unvaccinated, 30 (22%) had undocumented vaccination status, 11 (8%) had received 1 dose of measles-mumps-rubella (MMR) vaccine, 11 (8%) had received 2 doses, and 1 (1%) had received 3 (documented) doses.

    If Coulter wishes to argue about the 1 (1%) case that received 3 doses of measles...don't even bother because the reason why a person might receive 3 doses are varied...including previous travel abroad if the one case was over 6 month of age but under one year of age to a country where measles is endemic or between those same ages and living in an area with a measles outbreak. Under such circumstances, an infant would receive the recommended 2-dose series after the recommended one year of age.

    There is much more information contained in this HAN about the tens of thousands of cases in Europe and throughout the world of measles cases

    @Coulter

    as well as learning more about treating said disease. I didn't realize it was ONLY because we got better at keeping people alive

    Learning more about treating the disease is part of keeping people alive. As to better sanitation, measles is not affected by improvements in sanitation. It is an airborne virus. The only environmental precaution that might reasonably affect transmission is reduced crowding/contact with others.

    Isn't that also a condition some may suffer from complications from the vaccine as well?

    At a much, much reduced risk. Encephalitis affects about 1-2 per 1,000 individuals infected; the vaccine has a combined risk of encephalitis or severe allergic reaction of about 1 in 1,000,000. And even with all we know and can do to treat measles, there is still a 2 per 1,000 risk of death. It is not a mild disease to brush off as insignificant.

    Coulter,

    Isn't that also a condition some may suffer from complications from the vaccine as well? 269 events of encephalitis reported to VAERS following MMR (or similar) post-vaccination.

    You might want to read this paper, 'Genetics and the myth of vaccine encephalopathy' which concludes:

    Overall, there is no evidence to suggest that vaccines cause central nervous system injury, epilepsy or infantile spasms.

    By Krebiozen (not verified) on 02 Sep 2011 #permalink

    @ Krebiozen: That's a terrific link you provided to a Canadian study that analyzes supposed cases of vaccine encephalopathy.

    @ Jen: The only useful (and unusual) AoA discussion on this survey is the extraordinarily unusual fact that AoA has not heavily moderated (into non-existence) comments that analyze the internet survey for its validity and found it to be a totally junk survey. I suggest you read Kevin Hubbs' analysis that he posted and the link that Hubbs provided...before AoA pulls it.

    How is the VAERS system scientifically sound?

    That would be because it's not. The VAERS system doesn't produce actual data. The only people claiming it does are antivaxxers.

    VAERS only provides a starting point for real studies.

    @ lilady - my post is being held back because I attached a link to the HAN page that you've copied.

    There is nothing to mistake and nothing to argue.

    Of the 139 case-patients who were U.S. residents, 86 (62%) were unvaccinated, 30 (22%) had undocumented vaccination status, 11 (8%) had received 1 dose of measles-mumps-rubella (MMR) vaccine, 11 (8%) had received 2 doses, and 1 (1%) had received 3 (documented) doses.

    139 - 30 (unknown) = 109.

    11 + 11 + 1 = 23 (21%) where MMR status was documented between 1~3 jabs. I'm not sure why you're fixating on the 1% (1 person) with 3 jabs. I'm not saying anything about it other than 21% of US residents who caught measles this year had between 1~3 MMR jabs. I'm not saying anything about where the measles came from.

    "there is much more information contained in this HAN about the tens of thousands of cases in Europe and throughout the world of measles cases"

    I agree. The UK is seeing its highest measles vaccine coverage in 13 years (over 90%) and still sees measles breaking out, over 650 cases confirmed so far.

    According to WHO of the 11,000 cases of measles reported by April 2011, almost 25% were vaccinated.

    Congratulations Coulter, you've just shown the measles vaccine is extremely effective. What exactly are you trying to argue about?

    Also, sanitation has no effect on an extremely infectious airborne pathogen. The drop in measles mortality is due to advances in medical technology, not improvements in sanitation.

    @ Krebiozen: pubmed/4182814

    Can Med Assoc J. 1975 Apr 19;112(8):972-5.
    Encephalitis after administration of live measles vaccine.
    Jagdis F, Langston C, Gurwith M.
    Abstract

    In a previously well child with no evidence of pre-existing immunologic defect a fatal encephalitis developed 10 days after administration of measles vaccine. There was pathologic evidence of an early viral encephalitis characterized by perivascular mononulcear infiltrates. Although the virus was not recovered, the diagnosis of a measles virus infection and encephalitis is supported by the postmortem findings of Warthin-Finkeldey cells in lymphoid tissues, an intranuclear inclusion in the brain and histologic changes of encephalitis.

    The drop in measles mortality is due to advances in medical technology, not improvements in sanitation.

    Could you please post the peer reviewed study that you acquired this conclusion from. What specific medical technology are you speaking of? Does it quantify the improvements so as to distinguish it from the contribution of other confounders. As your fellow science bloggers would say "If you claim it then you must prove it".

    Why did you choose to dismiss nutrition as a factor in measles mortality? Is that because of bias or evidence?

    By augustine (not verified) on 02 Sep 2011 #permalink

    "11 + 11 + 1 = 23 (21%) where MMR status was documented between 1~3 jabs. I'm not sure why you're fixating on the 1% (1 person) with 3 jabs. I'm not saying anything about it other than 21% of US residents who caught measles this year had between 1~3 MMR jabs. I'm not saying anything about where the measles came from."

    If you knew the basics of epidemiology, then you would know you cannot just lump those who received 1 jab with those who received 2 jabs and the one case who received 3 jabs and declare that 21 % of U.S. measles cases were immunized:

    Firstly, the 23 cases that you lumped together do NOT equal 21%. I don't know how you came to the 21 % percentage (23 cases divided by 139 cases = 16.5 %...not 21 %).

    Secondly, the 11 cases (8 %) that you label as people whose MMR status is known who received only one dose of measles have not completed the recommended 2-dose series and therefore are not considered immunized.

    The report from the CDC Health Advisory that I cited is correct.

    "According to WHO of the 11,000 cases of measles reported by April 2011, almost 25% were vaccinated."

    Please provide a citation (title and date) for this WHO report...don't bother with a link, so that we can analyze it.

    @lilady

    You seem to be having a parsing error. Of the 139 total cases, 109 had known vax/un-vax status. Coulter's numbers flow from there (23/109=21%) - the 30 unknown-status cases are being disregarded, which is appropriate for this discussion (but it does introduce a source of bias). Your point about the single dose not being considered immunized is spot-on.

    Given that efficacy is advertised as 99.7% from 2 jabs and over 90% from one jab there is no reason to not lump them together as being "vaccinated", I would agree that there are no conditions under which you could properly say someone has been immunized given how many cases of measles occur in those who have been said to have been properly immunized.

    It is the WHO Epidemiological Brief - June 2011 from the regional office for Europe.

    And if we analyze your nomenclature and their statement that over 75% were not immunized, then we must logically conclude that almost 25% had at least 2 MMR doses as you have stated that immunization would not occur from one dose.

    See what I mean by CHS not answering my simple question. CHS, answer the question here!

    Coulter, when you were in school did you get to good marks by answering a different question than what was written on the exam? I was very specific when I said to explain why the incidence (and "morbidity" is defined as incidence of disease) of measles in 1970 was 10% of what it was in 1960 in the USA. I did not want to have any other decade mentioned. Did you not understand that?

    Again, here is what I said:

    So, exactly was the incidence/morbidity of measles in 1970 only 10% of the levels in 1960 in the USA? What happened to bring down the numbers so dramatically? And please only answer about that decade.

    Also, be aware that the MMR was not approved for use in the USA until 1971. That was after the period of 1960 to 1970.

    CHS (and now Coulter) answer the question here. I have absolutely no intention of goint to CHS' incoherent blog. No other question, no other disease, and only on incidence (which is morbidity) of measles between 1960 and 1970 in the United States of America. And present the answer in the comments here. It is really a simple answer, I don't understand why you avoid it so much.

    Why did you choose to dismiss nutrition as a factor in measles mortality? Is that because of bias or evidence?

    Are you really trying to claim that nutrition in the United States vastly improved from the 1950's to 1960's?

    Provide evidence to back your claim.

    I am also very specific about only discussing morbidity, the incidence of disease, in my question. This is because it limits the numbers of variables. There are more variables affecting mortality (hospital care, medication, etc) than morbidity.

    And remember, just like we dislike folks redefining words: changing the question and answering what was not asked is also frowned upon.

    I am also very specific about only discussing morbidity, the incidence of disease, in my question.

    No, you're specific about that endpoint because you can't pin down WHY mortality was dropping before the vaccine came into use.

    Besides, incidence has no meaning to people unless it's attached to a correlating mortality. It would be really really tough to SCARE people into buying a vaccine for a virus that caused ZERO mortality but had 100% incidence.

    Incidence isn't that big a deal by itself.

    By augustine (not verified) on 02 Sep 2011 #permalink

    @ Coulter: Thank you for the WHO reference...I wonder if you read it. I'm quoting directly from the WHO report:

    There were 11,146 cases reported and "for 66.1 % (7,245 persons according to my calculations) data on immunization status are not available"

    "Of the 11,146 cases reported only 1.5 % (171 people) had received two doses of vaccine, while 39 % were vaccinated with one dose and 25 % were not vaccinated"

    "According to WHO a person immunized with two doses of measles containing vaccine is protected-immune to measles. (Measles Vaccines: WHO Position Paper; WER No. 35, 28 August 2009; 84:349-60)"

    I suspect that you are confused with the statistics offered and confusing the numbers...let me try to unconfuse you.

    For 66.1 % (7,245) of the cases data on immunization status are not available.

    For the remaining 33.9 % (3,901) cases data on immunization status is known; only 171 people are reported as measles cases who are considered immune by WHO standards (they received the recommended 2-dose series)

    You should also read the WHO narrative describing the outbreaks of measles in European countries as NOT vaccine failure but rather failure to vaccinated with the two dose series.

    @ Chris - "I did not want to have any other decade mentioned."

    Of course you didn't! Because if you included another decade it would ruin the answer you're hoping to see to the question. Utterly transparent loaded question.

    @ lilady - thanks for that, I should have read further. So of those where status is known, just over 4% were fully "immunized", vs the US outbreak where 11% of cases were fully "immunized".

    Might I add (IMO), the public health departments of the various European member countries are overwhelmed by the 11,146 cases of measles reported by the WHO report, referenced by Coulter. For the vast majority of cases with unknown data on immunization status (7,245 cases), I suspect that they will never report immune status, due to the ever burgeoning numbers of new cases being reported.

    Hi Chris.
    Int. J. Epidemiol. (1982) 11 (1): 15-25. doi: 10.1093/ije/11.1.15

    The analysis reveals that there was a trend towards lower incidence rates of measles, and towards younger average age of cases, for the 10 years prior to commencement of the national immunization programme in 1968.

    It appears that the total number of individuals susceptible to measles has remained relatively constant, between 4 and 4.5 million, before and after the immunization programme.

    Hmmm... that turns out to be: Measles in England and WalesâII: The Impact of the Measles Vaccination Programme on the Distribution of Immunity in the Population.

    So, you have decided that both Wales and England were part of the USA between 1960 and 1970? I am sure there are several here who actually live in Wales and England that would dispute that!

    Oh, and since the whole paper is not available without paying, I suspect you will find that there is a cyclic character to measles outbreaks. This is shown quite well in this plot (from a link I posted earlier).

    So, really, why is it so hard to answer why the incidence of measles plummeted between 1960 and 1970 in the USA, and kept going down, and has never been more than half the level of 1970?

    "So, you have decided that both Wales and England were part of the USA between 1960 and 1970?"

    So have you decided that all other countries are irrelevant in your little quest?

    Coulter:

    So have you decided that all other countries are irrelevant in your little quest?

    Yes, since it reduces the number of variables. You've never done parameter studies, have you?

    So, why can't you answer the question? I even gave you a hint by linking to a paper (a whole paper, not just the abstract). I suggest you read, then you will be able to answer the question.

    Also, the choice of country is very important. As I found when I read this paper (whole paper, not just the abstract). In the introduction it says:

    The situation in the UK contrasts with the USA, where vigorous efforts have been made to promote immunisation. Uptake rates of over 95% have been achieved, and this has resulted in a notification rate of 0 7 cases per 100 000 population.'

    So comparing the UK and the USA would not be equivalent.

    Now, what caused a 90% drop of measles incidence between 1960 and 1970 in the USA?

    Here is an article from the MMWR May 27, 2011 issue:

    Measles-United States January-May 20, 2011

    Fortunately, we in the United States are not (yet) overwhelmed with measles cases...in spite of the number of cases where the "index" case brought the disease back from Europe and other measles endemic countries and were not immunized against measles...and in spite of the number of secondary and tertiary transmissions to people who are not immunized and linked to the index cases.

    "During January 1--May 20, 2011, a total of 118 cases were reported from 23 states and New York City (Figure 1), the highest reported number for the same period since 1996 (Figure 2). Patients ranged in age from 3 months to 68 years; 18 (15%) were aged less than 12 months, 24 (20%) were aged 1--4 years, 23 (19%) were aged 5--19 years, and 53 (45%) were 20 years and older. Measles was laboratory-confirmed in 105 (89%) cases, and measles virus RNA was detected in 52 (44%) cases. Among the 118 cases, 105 (89%) were import-associated, of which 46 (44%) were importations from at least 15 countries (Table), 49 (47%) were import-linked, and 10 (10%) were imported virus cases. The source of 13 cases not import-associated could not be determined. Among the 46 imported cases, most were among persons who acquired the disease in the WHO European Region (20) or South-East Asia Region (20), and 34 (74%) occurred in U.S. residents traveling abroad.

    Of the 118 cases, 47 (40%) resulted in hospitalization. Nine patients had pneumonia, but none had encephalitis and none died. All but one hospitalized patient were unvaccinated. The vaccinated patient reported having received 1 dose of measles-containing vaccine and was hospitalized for observation only. Hospitalization rates were highest among infants and children less than 5 years of age (52%), but rates also were high among children and adults ages 5 years and older (33%).

    Unvaccinated persons accounted for 105 (89%) of the 118 cases. Among the 45 U.S. residents aged 12 monthsâ19 years who acquired measles, 39 (87%) were unvaccinated, including 24 whose parents claimed a religious or personal exemption and eight who missed opportunities for vaccination. Among the 42 U.S. residents whose ages were 20 or older who acquired measles, 35 (83%) were unvaccinated, including six who declined vaccination because of philosophical objections to vaccination. Of the 33 U.S. residents who were vaccine-eligible and had traveled abroad, 30 were unvaccinated and one had received only 1 of the 2 recommended doses."

    I suggest Coulter check the MMWR for the measles outbreak in Minneapolis (Hennepin County) associated with a Somali child who brought the disease back following travel to Africa, taking particular note of the other Somali children who were infected, who in turn were responsible for terciary transmission of measles. Coulter might also look into the role of Andrew Wakefield in this outbreak...his latest "theory" is that Somali children have a larger incidence of autism...attributable to the MMR and other vaccines. Wakefield made three trips to Minneapolis this past year to speak to the Somali population about this "theory"; not quite a "Typhoid Mary", but Wakefield is a public health menace.

    It appears that "Coulter" is from Europe...my guess the UK ("jabs"), so why doesn't Coulter start a fund-raiser for Wakefield's legal expenses to appeal the BMC's decision to remove his license to practice medicine...being that Wakefield high-tailed it out of the UK and went to Texas and decided to not appeal the decision.

    lilady:

    It appears that "Coulter" is from Europe...my guess the UK ("jabs"), so why doesn't Coulter start a fund-raiser for Wakefield's legal expenses to appeal the BMC's decision to remove his license to practice medicine.

    Slight correction, it was the GMC.

    Hi Chris,
    Just trying to find out where in those links it states that the vaccine coverage was over 95% in the decade you're interested in discussing.

    "Just trying to find out where in those links it states that the vaccine coverage was over 95% in the decade you're interested in discussing."

    Do you mean 1960-1970? That's the decade she discussed above.

    I only ask because they didn't need 95% coverage then since a large fraction of the population already had immunity due to infection.

    Surely that is pretty obvious.

    @ Chris: Don't expect an answer from Coulter and thanks for the correction. Getting back now to my question, "It appears that "Coulter" is from Europe...my guess the UK ("jabs"), so why doesn't Coulter start a fund-raiser for Wakefield's legal expenses to appeal the BMC's (GMC's) decision to remove his license to practice medicine."

    I for one would contribute to Wakefield's "Appeals Fund" to challenge the GMC decision...with the provisions that the fund is set up in the U.K. administered by a trustee for that specific "appeal" and Wakefield gives up his green card for re-entry into the United States.

    It seems like just yesterday (and I believe it was yesterday) that I mentioned Harris Coulter in another discussion here. Harris Coulter is the homeopathy advocate and antivaxer who has expounded the theory of a "post-encephalitic syndrome" caused by vaccines, which he suggests is responsible for Ted Bundy and other notorious killers. Plus he has his very own whale.to antivax page, where he spouts drivel like the following:

    "...in fact it was my knowledge of homoeopathic theory and practice which made me aware of the evils of childhood vaccinations."

    So, is the Coulter who is sharing antivax sentiments in this thread the esteemed Harris Coulter, or just someone inspired by his example?

    By Dangerous Bacon (not verified) on 02 Sep 2011 #permalink

    Coulter re: #129
    Do you really think that a 36-year-old report of a child developing viral encephalitis after measles vaccination is good evidence that current vaccines cause encephalitis?

    By Krebiozen (not verified) on 02 Sep 2011 #permalink

    Coulter, you should start with the paper I cited, and actually read the papers I linked to.

    Dangerous Bacon, Harris Coulter died last year.

    @ Dangerous Bacon: You are my hero and I nominate you for the "RI Hunting Down the Quack on the Internet Award"...but one question:

    What the hell took you so long; while I and others have been wasting our time here on Coulter?

    Ooops, make that almost two years ago. From his obituary:

    COULTER HARRIS LIVERMORE COULTER, Ph.D. Died on October 28, 2009, at the age of 77, after a long struggle with stroke damage. Born in Baltimore, MD on October 8, 1932, Coulter attended Milton Academy and Yale University (1954). He earned a master''s degree (1961) and doctorate (1969) from Columbia University, NY in Russian studies and political science. Coulter worked for the State Department and the United Nations as an English/Russian interpreter. He authored nine books on medical history. He is survived by his sons, Andrew and Alex; and daughters, Elizabeth and Marian. No services will be held.

    Wow, he was an interpreter and historian. No real education in medicine. And we were supposed to believe anything he said about vaccines and medicine?

    Actually, lilady, it is kind of fun to see all of the shenanigans these guys do to get out answering my very simple straight forward question. It is not the first time that the measles rates of Wales and England have been brought up. I swear these guys have the same issues with geography with the folks who claim homeopathy is not "western" (when did Germany shift towards China?).

    Chris

    And we were supposed to believe anything he said about vaccines and medicine?

    Oh and you're an engineer. OK. And Orac is an expert on vaccines because of what educational degree?

    BTW, are you going to be watching DWTS?

    By augustine (not verified) on 02 Sep 2011 #permalink

    Did someone say "Coulter"? There is a Catherine R. Coulter who is listed on the internet and associated with homeopathy and "vaccines"....some of the homeopathy quacks who "treat" and "cure" autism reference Catherine R. Coulter...(not to be confused with Catherine Coulter...a contemporary suspense thriller author)

    Could Catherine R. Coulter be "our Coulter"?

    Liladay, you're science blogs's Deputy Dawg...or Barney Fife.

    By augustine (not verified) on 02 Sep 2011 #permalink

    "The lovely cuddly David says LOL:"

    I asked you for evidence that we as a group deserved and instigated your behaviour. In your defence, you quote merely one of us. You are abusive to everyone, not just those that bad mouth you.

    Many of your examples had feck all to do with you yet you personalised them anyway. As for calling them 'abuse'? You must have very thin skin and a weird sense of proportion if you think thay are in anyway equivlant to the vicious and vindictive abuse you gave out and are continuing to give out.

    You were the one that crossed the line from negative and unfriendly into outright abusive. You are nasty and vindictive, you blame others for your woefully disproportionate behaviour and you have difficulty controlling yourself.

    Admit to it and deal with it.

    Pointing to mild behaviour by others neither explains nor justifies your rather extreme behaviour.

    Coulter:

    Just trying to find out where in those links it states that the vaccine coverage was over 95% in the decade you're interested in discussing.

    Who ever claimed that? The quote I used was from a different decade, and it was showing that the USA and UK were not equivalent. They are separate countries with their own policies (didn't you take World History in high school?). The paper even talks about different policies of other countries, and even Scotland!

    Besides, it would have been numerically impossible for a 95% coverage due to at least three years before something happened? Do you know what happened? And it was not the MMR.

    Ignoring ignorant pathological liar filthy-mouthed troll.

    The lovely cuddly David says LOL:

    The cad! How dare he!

    By Militant Agnostic (not verified) on 02 Sep 2011 #permalink

    Haha "The Bolen Report". It's Kwality with a kapital K. Love the shot in front of the tank, internet tough guy.

    I am often interested in the analyses done by the author here, but always leave saddened by the tone. I am not an idiot - I see "insolence" in the title - but there is so much sarcasm and nastiness herein. Does the world benefit in any way from being snide, or by calling people stupid even if they are less intelligent or thoughtful than we are?
    It seems to me just as unscientific (though I get that it's human nature) to cast aspersions on an entire demographic, whether it be acupuncturists, people concerned about injecting chemicals into their precious children, or hot dog vendors, as it is to publish pseudo-science and poorly crafted studies in defense of a specious argument.
    I think you could reach more people without the snark. Just sayin'.

    Spammer you are not welcome here...get lost.

    Tone trolls are more than welcome to post here...but I wonder why Yucie who has never posted on RI or any SBM blog has decided to crawl out from beneath its troll bridge now.

    Was there any information you wish to add to this discussion or are you just doing some trolling and name calling...that's really very juvenile behavior on your part.

    Yucie...feel free to run to the "other side" or back where you came from. Your science isn't soft it is non-existent. Paradoxically your have indulged in name calling and have mentioned my buttocks in the same sentence as your so-called science.

    Also provide some hugs to the so-called victims.

    Yucie:

    Every neuron in my brain says that your science is to be followed but my tummy is asking me to look around for your victims - they need a cuddle!

    Orac's "victims" include John Scudamore, a vile and quite probably mentally unbalanced individual who runs whale.to, a poisonous website containing the "Protocols of the Learned Elders of Zion" - an antisemitic fraud exposed as such in the 1920's - and his "theory" that his bottom was once burnt by "satanic ley lines"; Mike Adams and Gary Null, medical "entrepeneurs" (read "quacks") who attack proper science-based medicine and hawk dubious "cures"; and various antivaxxers like Jenny McCarthy and the Age of Autism gang, who lie about vaccines to discourage parents about vaccinating.
    So take your Tone Trolling and stick it where the sun don't shine.

    @ Julian Frost...Yucie has attacked me not Orac with his references about "victims" and buttocks...and now my height and "circumference".

    I suspect Yucie is mentally deranged and belongs on another site, where someone who welcomes his filth, might find his suggestive remarks attractive.

    Yucie you are just a filthy-mouthed odious troll and deserved to be ignored. Too bad Orac doesn't put you in moderation purdah.

    Shoo, Jacob.

    You called it. The cannabis troll is back, taking advantage of my all-too-brief downtime sleeping to evade the filters. One wonders why he does it, given that inevitably he's found out when I get up. Goodbye, Jacob. Again.

    Thanks Orac. I felt downright creepy with this stalker,

    Seriously, Ms. Beckett, Mercola?

    Even the greatest scientist of them all got it wrong.........may times......So now we know that the speed of light is NOT the fastest traveller in the universe..........and many other laws of quantum physics have been dealt a death blow oh and so to Nano particles and on i could go......nuclear science is safe and we can control it HAHAHAHAHAHA....................truth is we still don't know the causes of genetic mutation, nor how all the chemical reactions in the body take place............or from another angle , look at the wonderful advancements in neuro science and medicine and what we can now do with stroke victims or serious brain injuries and there rehabilitation...........i live with the consequences of vaccination everyday, i had a normal healthy 2 yr old girl one day, immunised the next - brain swelling and oh boy how life has changed............5 yrs later and i challenge ANY of YOU to Walk a MILE in my SHOES ...................then tell me vaccination is safe

    What..........the hELL..........is............with the......uhhh.........unique.......CaPitaLization........and......punctuation that.......antivax loonies.....USE????

    If you are striving for an effect, I'm afraid the effect is "psychotic".

    @ TBruce

    It's how they talk. Try the following exercise: Read one of their posts out loud. Put emphasis on any capitalized letter and extra-double-emphasis (i.e. shout) for any fully capitalized word. Pause for effect at elipses, and really pause on the super-elipses. The effect is even better if you wear a tinfoil hat while doing this.

    Of course, I don't recommend doing this where anyone who cares about you can hear it.

    Even the greatest scientist of them all got it wrong.........

    Absolutely. After all, only a truly arrogant person would pretend they are never wrong about anything. You wouldn't be one of those, would you?

    So now we know that the speed of light is NOT the fastest traveller in the universe..........

    Really? You believe the currently-unconfirmed results of that experiment right after pointing out that even the greatest scientists of them all get it wrong many times? The scientists involved didn't even claim that things can exceed light speed; they said that they'd gotten a very surprising anomalous result, which could be experimental error but they weren't sure, and which would be revolutionary if true. So they did what any properly humble scientist would do -- they published their results and invited others to study them, question them, criticize them, and, most importantly, attempt to replicate them. So far, it has been neither confirmed nor disproven, though consensus is leaning slightly towards it being experimental error.

    and many other laws of quantum physics have been dealt a death blow oh and so to Nano particles and on i could go......

    Really? I don't suppose you could list what portions of quantum physics have been dealth a death blow? Or explain what you mean by mentioning nanoparticles?

    nuclear science is safe and we can control it HAHAHAHAHAHA....................

    Oh, absolutely we can control it. However, as with all else in this vale of sin and woe, we do not always live up to our ambition, and so we are not always successful. Things happen. People screw up. They fail to forsee potential accidents, or they take shortcuts, or they just make honest mistakes, and then bad things happen. And sometimes there's overt negligence involved. People are people, after all.

    Safe? Safe is relative. Burning coal for the next century will likely do considerably more damage than using nuclear power for the same duration; it's just that while nuclear reactor damage is usually due to accident, the damage due to coal burning is pretty much inherent in the system. Which is better or safer? Depends on exactly how you ask that question, and what factors are important in deciding what to consider safe. After all, *nothing* is completely safe.

    truth is we still don't know the causes of genetic mutation, nor how all the chemical reactions in the body take place............

    We don't know *all* the causes or all the chemical reactions, but we do know a great many. That our knowledge is imperfect does not mean it is absent.

    or from another angle , look at the wonderful advancements in neuro science and medicine and what we can now do with stroke victims or serious brain injuries and there rehabilitation...........

    Case in point, right there. Obviously, we do know a lot, and are continuing to learn more and more all the time. It's a wonderful thing.

    i live with the consequences of vaccination everyday, i had a normal healthy 2 yr old girl one day, immunised the next - brain swelling and oh boy how life has changed............

    I cannot judge your claim; I know of many cases of people who blame vaccines for what was not caused by them, and I know of a few cases where vaccines were the trigger for a genetic time bomb that was going to go off anytime the child had a fever, and I know of a few cases where the vaccine itself actually caused serious problems which would not have been caused by anything else. So I'm sorry, but I cannot conclude much from your statement. I do not know which sort of case your daughter is, which means I have no way of extrapolating from that to what I should do with my own daughters.

    So instead I look at populations. Not what allegedly happened to one child, but what was documented as happening to thousands of people in clinical trials, and millions in post-market surveillance. Vaccine side effects are real, but extremely rare. Just as I am not worried about being struck by the falling Phobos-Grunt spacecraft (likely to return in a month or so with a huge load of toxic hypergolic propellants on board), I'm also not worried about adverse side effects beyond pain at the injection site and possible mild flu-like symptoms the next day. I'm aware of them, and so I will watch for them, but I'm not worried. I don't like to worry without cause; it just depletes my stress reserves before an actual crisis. My children are fully vaccinated, and I will make sure they continue with their shots to complete each series, and receive necessary boosters until they reach the age of majority and begin tracking this stuff on their own.

    5 yrs later and i challenge ANY of YOU to Walk a MILE in my SHOES ...................then tell me vaccination is safe

    Walk a mile in the shoes of a parent who has lost a child to pertussis, or a child severely brain damaged by measles. Or the shoes of a friend of mine, who lost one child and had another become severely disabled in an act of God. Or the shoes of another friend, who lost a child to disease that is not vaccine-preventable. This stuff is *hard*. I won't pretend otherwise. But we cannot conclude anything about the safety of vaccination from knowing that it's hard to parent a child with disabilities.

    Anecdotes cannot generally guide our decisions about medical care; they are not reliable, because there are too many possible explanations for what has happened. What they can do is tell us why it is important to *care*. It is terrible when a child becomes disabled, and we should avoid that as much as possible. But if vaccination will result in 100 children out of a million becoming brain damaged, while not vaccinating will result in 100,000 children out of a million dying or suffering brain damage, then it is pretty clear which should be done.

    By Calli Arcale (not verified) on 15 Dec 2011 #permalink