Respectful Insolence

I had been wondering why the anti-vaccine crank blog Age of Autism had been gearing up the slime machine against Brian Deer lately. For example, former UPI reporter turned vaccine/autism cran Dan Olmsted has been attacking the BMJ. As you recall, the BMGpublished Brian Deer’s latest revelations earlier this year when he quite pithily and correctly referred to the now infamous (not to mention fraudulent and consequently retracted) 1998 Lancet case series published by vaccine/autism quack and crank Andrew Wakefield “Piltdown medicine.” Particularly curious are the more recent articles, which try to cast doubt on Deer’s reporting about Child 11, in essence calling Brian Deer a liar when he reported that Child 11′s symptoms of autism developed before he got the MMR vaccine, hitting that theme a week ago and then again earlier this week. I had been curious why Olmsted had resurrected his putrid yellow journalism directed at Brian Deer, after not having added to the series (An Elaborate Fraud) since part 6 in August.

Now I know. It’s a preemptive strike.

Just yesterday, the BMJ published another followup article by Deer entitled Pathology reports solve “new bowel disease” riddle that further elaborate on the the real “elaborate fraud,” namely Andrew Wakefield’s fraudulent research that ignited a scare about the MMR vaccine as a cause of regressive autism. It is a scare that has not yet abated, even nearly 14 years after the publication. It was a scare based on the claim by Wakefield that he had identified a new syndrome, which he later dubbed “autistic enterocolitis” in a followup paper in the American Journal of Gastroenterology. This syndrome, Wakefield suggested, was associated with vaccination with the MMR vaccine, and The Lancet paper, which linked autism and “autistic enterocolitis” with the MMR served as the basis of Wakefield’s later claims that the MMR vaccine was a cause of regressive autism. Thirteen years and multiple studies later, no investigator not somehow associated with either Wakefield and/or the anti-vaccine movement has been able to replicate his work. Indeed, an explicit attempt to replicate Wakefield’s work failed utterly. After all that time, there remains no persuasive evidence that such a syndrome as “autistic enterocolitis” even exists. Indeed, Deer found in his investigation that the vast majority of specimens that the gut was normal but only after a re-review by Wakefield’s team were they described as abnormal.

In any case, this alleged new syndrome depended on the finding of “colitis” in ileal biopsy specimens from autistic children in Wakefield’s original case series. In his book Callous Disregard, Wakefield claimed that he “played no part in the diagnostic process at all” and:

It was decided that, in order to standardize the analysis of the biopsies, the senior pathologist with the most experience in intestinal disease, Dr. Paul Dhillon, should review all biopsies from autistic children. In turn, Dhillon decided that pathology should be graded on a reporting form designed by him to document the presence and severity of microscopic damage. Thereafter, a regular review of biopsies took place involving Drs. Dhillon and Anthony, a trainee pathologist. I was also in attendance. Dhillon’s diagnosis formed the basis for what was reported in The Lancet.

Unfortunately, as Sullivan notes, these statements have been difficult to verify, and the original pathology slides made from biopsy samples taken from the original children studied in Wakefield’s case series are missing, which obviously makes it impossible to go back and look at the specimens and see whether expert pathologists agree with Wakefield’s team or not. This does make me wonder what happened to the original pathology blocks used to make the slides. If those still existed, it would be possible to cut and stain more sections. In fact, it makes me wonder how all of these specimens, slides, blocks, and all, could go missing. Be that as it may, it’s also interesting that Dr. Dhillon’s original scoring sheets were also missing.

Until now.

Deer got ahold of the original scoring sheets, as he describes here:

Between 1988 and 2001, Wakefield was an academic researcher at the Royal Free medical school in Hampstead, north London, from which his five page paper was published. “Researchers at the Royal Free Hospital School of Medicine may have discovered a new syndrome in children involving a new inflammatory bowel disease and autism,” the school announced to promote the paper, which the Lancet retracted last year.

But the data–passed to us by David Lewis, a self employed American environmental microbiologist working with Wakefield–tell a different story, kept hidden for nearly 14 years.

The funny thing is that Lewis forwarded these reports to the BMJ because he thought they exonerated Wakefield, probably leading Wakefield now to wonder, “With friends like these, who needs enemies?”

What Deer got ahold of where Dhillon’s histology scoring sheets for 62 intestinal biopsy specimens from 11 of 12 of the Lancet children, and it turns out that Dhillon’s reports actually showed nothing particularly unusual. Deer reproduces some of the grading sheets in his article and on his website. For example, here’s the scoring sheet for Child #1 and for Child #2. It turns out that Dhillon did not find frank enterocolitis in any of the children, and in fact, quite the contrary to what was reported in The Lancet paper, what is recorded in these reports is far more consistent with normal intestinal mucosal than with any significant enterocolitis:

But Dhillon’s reports produced results that pathologists, gastroenterologists, and a gastrointestinal immunologist to whom we have shown them say are overwhelmingly normal and might be found in almost anybody’s gut.

“Most of this stuff is so close to normal that you’ve really got to question whether there is really anything there,” said Henry Appelman, professor of surgical pathology at the University of Michigan and a specialist in gastrointestinal disease. “These are the kind of things that we in our practise here would ignore completely.”

By way of background, remember that these specimens were nearly all read as normal by consultant histopathologist Susan Davies, who also challenged claims of “colitis” in a draft of the original Lancet paper withdrew her objections in favor of Dhillon’s analysis. However, as Deer reports:

But it now emerges that, although expressed as scores rather than narratives, Dhillon’s findings were largely consistent with Davies’s. “Everyone thinks I am crazy even asking them,” said King’s gastroenterologist Bjarnason, after discussing the scorings with other specialists. “All but one of the children is normal in their eyes. There is no enteritis and no colitis, simple as that.”

There was at least one other major problem, and that’s what was left out of the reports that might have put even the mild changes noted in the intestinal biopsies. What was left out was a history of severe constipation. For example, one of the patients endured failure to pass the endoscope because there was still fecal matter in the cecum, even after a full bowel prep. This is very important because pathologists, if they knew about this, would think less of even the mild changes observed, mild inflammation and lymphoid follicles, are common in biopsies of patients with severe constipation.

In a second article in the same issue of BMJ entitled MMR fraud needs parliamentary inquiry, says BMJ, as new information puts spotlight on Wakefield’s co-authors, BMJ editor-in-chief Dr Fiona Godlee goes one further than Brian Deer in that she asserts that at least six other papers by Wakefield besides the Lancet paper require “independent investigation.” She sent a letter to Andrew Miller MP arguing that Parliament must investigate University College of London, where the research was carried out, unless UCL immediately starts an independent inquiry:

“If UCL does not immediately initiate an externally-led review of its role in the vaccine scare, we believe that parliament should do it,” concludes Godlee. “After the effort and time it has taken to crack the secrets of the MMR scare, and the enormous harm it has caused to public health, it would compound the scandal not to heed the warnings from this catastrophic example of wrongdoing.”

Amusingly, Lewis, stung that his attempt to exonerate Wakefield by supplying the pathology scoring sheets to the BMJ has backfired so spectacularly and actually made the Wakefield team look even worse, is mounting a counterattack by writing a letter to the BMJ. Basically, his argument boils down to trying to claim that Wakefield was just “reporting what he was told” and had nothing to do with shaping the analysis of the bowel samples. In other words, Lewis is arguing that Dhillon and Wakefield were incompetent, although that’s not what he calls it. However, that’s not what the General Medical Council found after two years to investigate the matter. It concluded that there was fraud involved.

Hilariously, Lewis discusses learning of Deer’s stories earlier this year while at a “vaccine safety conference” with Wakefield. It’s hard not to note that if you say you’re at a “vaccine safety conference” with Wakefield, it was in actuality an anti-vaccine conference, and the conference to which Lewis refers is the infamous conference in Jamaica held earlier this year. There, Wakefield shared the bill with other anti-vaccine cranks such as Dr. Russell Blaylock (who is an all purpose medical crank and, like many all purpose medical cranks, anti-vaccine), Dr. Shiv Chopra (who is anti-vaccine to the core), and Dr. Richard Deth, Raymond Obamsawin, among others. Here’s a hint: While trying to defend and anti-vaccine crank like Wakefield, don’t bring attention to the fact that he’s an anti-vaccine crank by mentioning his having attended an anti-vaccine conference. Come to think of it, don’t mention your having attended the conference as well.

In the end, Deer’s latest findings are evolutionary, not revolutionary. It’s not clear why Lewis so wanted to exonerate Wakefield and clear his name that he was willing to persuade Wakefield to let him provide Dhillon’s scoring sheets to the BMJ, but I’m grateful that he was so clueless that he did so. In the absence of the original pathology specimens and the ability to get other pathologists to evaluate them, Lewis inadvertently provided the next best thing to help confirm once again the utter incompetence and fraud that is Wakefield.

Comments

  1. #1 Lawrence
    November 11, 2011

    I wonder if Wakefield is now liable for criminal prosecution – I know the laws in the UK are significantly different, but in this case, it is like someone who shouted “fire” in a crowded movie theater, resulting in people getting injured or perhaps killed in the stampede to the exits, without even a hint of fire, much less smoke.

    Obviously, the analogy applies to raising the alarm on the vaccine-autism link, without even a shred of evidence (and in face, showing that any presented evidence was not only false, but made up out of whole cloth).

  2. #2 blackheart
    November 11, 2011

    Always happy to hsee people offer their own diagnosis of the Lancet 12 children and what the underlying clinical diagnosis relating to GI symptoms was.

    Please try to include all the relevant findings including that found by the three paeditaric gastroenterologists.

    I’m sure there’ll be some interesting theories.

    Diarrhea or constipation …

    You see not only do you have to deconstruct an argument you also have to problem solve a solution that fits the requisite evidence.

    An apparent big vacuum in the skeptik schema.

  3. #3 palindrom
    November 11, 2011

    I wonder if the pathologist was aware of the gross misrepresentation of his results?

    Off-topic, but relevant to a post a few days ago, The Onion has picked up on the chicken-pox lollipop story with one of their man-on-the-street features:

    http://www.theonion.com/articles/chicken-pox-lollipops-ineffective,26588/

    The best response:

    Additionally, kissing a broken arm is not adequate treatment for such an injury. You have to rub it with a half-eaten Big Mac from someone else who has a broken arm.

  4. #4 Antaeus Feldspar
    November 11, 2011

    You see not only do you have to deconstruct an argument you also have to problem solve a solution that fits the requisite evidence.

    … did Th1Th2bot get loose and start posting under a new pseudonym?

  5. #5 Rainbow Dash, best pony.
    November 11, 2011

    Wow. Talk about shooting yourself in the foot. Embarassing.

  6. #6 Beamup
    November 11, 2011

    You see not only do you have to deconstruct an argument you also have to problem solve a solution that fits the requisite evidence.

    Leaving aside the fact that this statement is patently false – it’s not necessary to prove what’s right in order to conclusively demonstrate that Wakefield was wrong – there IS an obvious conclusion that perfectly fits the evidence. Namely, that Wakefield engaged in comprehensive and deliberate fraud for personal monetary profit.

  7. #7 govt employee
    November 11, 2011

    If this David Lewis was truly forced out of the EPA as a GS-15, then he would have either had to do something unethical or abusive in order to have been let go. The protections given to govt employees are extraordinary. The @aol.com email address he used for his contact information listed on a pubmed citation was everything I needed to know about his credibility. /snark

  8. #8 Science Mom
    November 11, 2011

    So his holiness Wakefield speaks on nigh through disciples now huh? It still boggles my mind the grip that this utterly, ethically-bankrupt buffoon has over some people and the lengths they will go to defend him.

  9. #9 Denice Walter
    November 11, 2011

    I imagine that “shock and awe” will follow promptly…

    Andy is not only the cherished darling of the anti-vaxx set but ranks highly amongst the pantheon of heroes dearly beloved by alt med mavens of all stripes: they characterise him as a scientific revolutionary who has unmasked the “fraud” of SBM’s infatuation with vaccines and has, almost single-handedly, bravely undermined the public’s confidence in these “scandalous” inventions. Thus, pushback has already begun as I’ve reported previously. More will follow.

    A few years ago I inadvertently invoked the wrath of a person who had “problems with impulse control” ( amongst other issues): a friend succinctly queried, “How’s the security at *your* building?”

    When you “kick the hornet’s nest” you should expect stings as the enraged swarm descends upon you. And anyone else in its path within striking distance- i.e supporters of SBM. I venture though that the “security in our building” is very good indeed.

    I find it hilariously satisfying that Wakefield was undone by the very means by which he sought exoneration. As though the universe itself had been conspiring to complete his entire and devastating ruination.( Not that I believe in stuff like that- it’s metaphorical and anthropomorphic but poetic- what can I say, I like it).

    Because Orac is known unto the furthest reaches of cyberspace as a supporter of SBM and vaccination, I suspect that much of the buzzing hive of chaotic thinking should land here. Makes you proud to be a target.

  10. #10 Science Mom
    November 11, 2011

    If this David Lewis was truly forced out of the EPA as a GS-15, then he would have either had to do something unethical or abusive in order to have been let go.

    Not necessarily and this is why whistle-blower protection laws have been implemented. However, it doesn’t sound as though this Dr. Lewis even has a whistle-blower case so he is left to kicking stones and shilling for Wakefield (who is NOT a whistle-blower by any stretch of the imagination).

  11. #11 Beamup
    November 11, 2011

    Didn’t one of his lackeys threaten a reporter with bodily harm if they weren’t nice to him?

  12. #12 Science Mom
    November 11, 2011

    @ Beamup, yes it was Michelle Guppy: http://www.nytimes.com/2011/04/24/magazine/mag-24Autism-t.html?pagewanted=all

    What a class following he has.

  13. #13 D6782
    November 11, 2011

    Did Dr. Dhillon’s scoring system for purported pediatric enterocolitis get validated in any published research (prior to the Wakefield “study”, or subsequently) as a legitimate means of evaluating disease, or was it conceived solely for the purpose of evaluating Wakefield’s small sample set?

    And just what did happen to the tissue blocks and slides? You’d think that if the findings of enterocolitis were legitimate, the actual tissue would hold evidence in support of Wakefield for reviewing pathologists to find.

    It’s hard to escape the conclusion that someone has been very careless or naughty.

  14. #14 Denice Walter
    November 11, 2011

    @ D6782:
    “someone has been very careless or naughty”

    It’s either a “someone” or a vast baroque imbroglio of a matrix of nested conspiracies immaculately maintained by the trans-Atlantic-pharma-medico-governmental-media cartel.
    “Someone” gets my vote.

  15. #15 brian
    November 11, 2011

    Wakefield wrote in Callous Disregard: “a regular review of biopsies took place involving Drs. Dhillon and Anthony, a trainee pathologist. I was also in attendance.

    Yet Wakefield earlier wrote in the Lancet aricle: “All tissues were assessed by three other clinical and
    experimental pathologists (APD, AA, AJW).”

    I suppose the fellow with the initials AJW who “assessed” the tissues wasn’t Wakefield. Perhaps that’s just a weird coincidence that explains why one of those statements from Wakefield would otherwise seem to be false; that should have been obvious, as Andrew J. Wakefield, who trained as surgeon, could never had credibly described himself as a “pathologist.”

    BTW, it’s also amusing to see how Wakefield’s boosters coordinated their efforts, as when John Stone inadvertently included in his post to Nature, according to an intersting post on the biology files:

    “Here is information to post on Nature” and this other oopsie in what was otherwise supposed to be a third-person reference: “editors at Annals of Internal Medicine rated me in the top 10% of its reviewers in 2010.15.” (Nature has since deleted the comment, which violated their “no self promotion” comment rules). In other words, Stone was serving as poster boy for David Lewis.

    http://biologyfiles.fieldofscience.com/2011/11/oh-what-tangled-web-we-weave.html

  16. #16 Science Mom
    November 11, 2011

    And just what did happen to the tissue blocks and slides? You’d think that if the findings of enterocolitis were legitimate, the actual tissue would hold evidence in support of Wakefield for reviewing pathologists to find.

    It’s hard to escape the conclusion that someone has been very careless or naughty.

    Exactly. When you perform a set of experiments that has the potential to blow the roof off of a convention (and even when you don’t), you make damn sure you keep your samples safe. I have tissue samples that I collected over a decade ago safely locked away in a freezer should they be needed. If I recall correctly, Dr. Afzal requested samples from Wakefield years ago and he refused. This rather important detail of “where are the samples” escapes his acolytes, conveniently.

  17. #17 Chris
    November 11, 2011

    Brian, John Stone resubmitted that comment without the initial bit, but he did not edit the sentence that used both “He” and “me.”

  18. #18 GlaxoPharma Com Orbital
    November 11, 2011

    MESSAGE BEGINS ————————

    Minion Walters,

    Like you don’t know who “someone” is. Slick. Very slick.

    Lord Draconis Zeneca, VC, iH7L

    Forward Mavoon of the Great Fleet, Suzerain of V’tar Pharmaca Magna of Terra, Chief Someone of the Orion Arm

    
PharmaCOM Orbital HQ
0010101101001

    
—————————————— MESSAGE ENDS

  19. #19 cervantes
    November 11, 2011

    BTW, I think Orac skipped over one of the important points, which is that despite finding nothing unusual in the specimens, Dhillon signed on to the paper as a co-author — evidently in full knowledge that its fundamental claim was completely false. He’s now a senior professor at UCL, as I understand it, which refuses to investigate or do anything about the situation.

  20. #20 Brian Deer
    November 11, 2011

    Here at the Deer Corporation (ticker: GSK, MRK, CIA), Christmas came early this year. So I wonder if I might use Orac’s good offices to send greetings to David L Lewis.

    Thanks for the Wakefield documents, David. If you get any more, I’m happy to pay the postage.

    Meanwhile, why not share this festive time with a song?

    http://www.youtube.com/watch?v=hI1nPd7hezM

  21. #21 MikeMa
    November 11, 2011

    Nice dig Brian Deer!

    Won’t shake the faithful but it does give the sane more reason to point and laugh at Wakers & Co.

  22. #22 Poodle Stomper
    November 11, 2011

    Very nice work, Brian! I wish only that all other fraudsters receive the same amount of exposing!

  23. #23 lilady
    November 11, 2011

    Christmas has come early here in the U.S. as well.

    David L. Lewis, I’ll pay for courier service to hand deliver Wakefield’s papers to Brian Deer.

    (I’m reminded of Nixon’s trusted White House Aide Alexander Butterfield, who first revealed during an interview with the Senate Watergate Investigation Committee, the presence of multiple recording devices in the Oval Office.)

  24. #24 rw23
    November 11, 2011

    @Lawrence #1:

    I wonder if Wakefield is now liable for criminal prosecution – I know the laws in the UK are significantly different, but in this case, it is like someone who shouted “fire” in a crowded movie theater, resulting in people getting injured or perhaps killed in the stampede to the exits, without even a hint of fire, much less smoke.

    IANAL, but I imagine the difficulty would lie in demonstrating the damage which Wakefield might have foreseen from his choice of action. He might just have thought that his initial ‘revelation’ would have benefited his paymasters and gone little further, rather than it becoming an intercontinental decade-plus cause celebre by which ignoramuses could advocate the early death, maiming and/or suffering of little children. But how would you go about proving that in court? To what degree are the ignoramuses to blame, as opposed to the instigator?

    Please, no-one flame me for suggesting that Wakefield could not be prosecuted. I would sincerely like to see him lose more than his licence to practise, pour encourager les autres.

  25. #25 Roadstergal
    November 11, 2011

    @RW23 #24: He did fan the flames and profit substantially, financially and otherwise. I wonder if that would have any bearing…

    IASUNAL.

  26. #26 herr doktor bimler
    November 11, 2011

    Always happy to hsee people offer their own diagnosis of the Lancet 12 children and what the underlying clinical diagnosis relating to GI symptoms was.

    “Diagnosis”? That implies a gut disease to be diagnosed. What part of “overwhelmingly normal” do you not understand?

  27. #27 rw23
    November 11, 2011

    @Roadstergal #24:

    True, but the justice system tends to go for specific events. If he’s got away with it this long, the odds of a prosecution being brought are low. Then again, in the UK we have seen over the last few decades more civil prosecutions allowed where criminal prosecutions have failed or where the Crown Prosecution Service has failed to make them. There may be an opening there. Unfortunately civil prosecutions don’t result in jail terms, to the best of my knowledge, nor in fines or recompense against monies held outside the EU (although once again I must say IANAL).

  28. #28 Denice Walter
    November 11, 2011

    @ Brian Deer:

    Well.. actually I was thinking of something like “Let the Punishment Fit the Crime”…
    At any rate, I bow gracefully in your general direction, sir.
    DW

  29. #29 rw23
    November 11, 2011

    @Roadstergal #24:

    PS. What does IASUNAL stand for? My google-fu fails me.

  30. #30 Chris
    November 11, 2011

    Antaeus Feldspar:

    … did Th1Th2bot get loose and start posting under a new pseudonym?

    No.

    herr doktor bimler:

    What part of “overwhelmingly normal” do you not understand?

    He has a habit of deliberately ignoring actual facts, and substituting his own interpretations. Something that is very apparent as he demonstrates in the aptly named “The fixed mindset of the anti-vaccine activist” article. It seems he also lives on Htrae.

    So I propose the following two nicknames:

    Th1Th2 = Thingy

    blackheart = ThingyJr

    And let us not forget the ever morphing nasty person who keep claiming there are vast quantities of vaccine damaged children, but can’t be bothered to post any evidence. And she really hates several researchers like Madsen, Forbonne, etc. She is Common Sue (even if this person is a guy), if for nothing else in “dishonor” of Sue M. who had a similar posting style (and who first morph was as “Common Sense”).

  31. #31 Roadstergal
    November 11, 2011

    I Am So Utterly Not A Lawyer. :(

  32. #32 rw23
    November 11, 2011

    @Roadstergal #30:

    Thank you — I couldn’t imagine a better vocation than IASUNAL!

  33. #33 GlaxoPharma Com Orbital
    November 11, 2011

    MESSAGE BEGINS———————-

    Dear Minion Deer,

    Word of your brilliant work has reached the homeworld and come to the attention of Her Imperial Highness, Clopidogra Invicta XXIII (may She live for all time). H.I.H. has instructed me through representatives of The Great Egg Mother of The Mist at Sandringham to proclaim you a Class VIII Shill with all that entails. You have also been awarded the coveted Glaxxon Order of the Platinum Hypodermic Cross which you may pick up at Bulgari at your convenience (176-177 Sloane Street, Knightsbridge
    London, SW1X 9QL). Make sure to use the correct Glaxxon PharmaCOM password of the day to receive your medal. You will also receive a year’s supply of Blaxill™ (moronoviramix hyperchlorate 5ml) Glaxxon PharmaCOM’s new intelligence suppressant for those nights when you just want to “get stupid” as you monkeys so quaintly put it.

    But wait, there’s more (I’ve always wanted to say that)! Your new status entitles you to free drinks at all Corpus holiday parties and, of course, the mink interior trim upgrade on your next private jet. Looking forward to meeting you in person at the PharmaCOM Phuntime Jamboree next summer.

    A raised battleclaw salute for your service to The Corpus! Now back to work! We have a planet to subjugate . . .

    Lord Draconis Zeneca, VC, iH7L
    
Forward Mavoon of the Great Fleet, Suzerain of V’tar and Pharmaca Magna of Terra, Smooth Operator

    PharmaCOM Orbital HQ
0010101101001
—————————————— MESSAGE ENDS

  34. #34 rw23
    November 11, 2011

    @Roadstergal #30:

    Or now that I’ve spotted the unhappy smiley, was my last comment crass and inconsiderate. If so, I apologise.

    [Shoots MWH self in head]

  35. #35 Luna_the_cat
    November 11, 2011

    [Shoots MWH self in head]

    Don’t. Just….don’t, please. Those of us who have lost people to suicide also get the flinches.

  36. #36 rw23
    November 11, 2011

    @Luna_the_cat #33:

    I am so sorry. It was a bad physics joke. I’ve lost friends and family too, and it’s just my twisted way of coping.

  37. #37 Science Mom
    November 11, 2011

    BTW, I think Orac skipped over one of the important points, which is that despite finding nothing unusual in the specimens, Dhillon signed on to the paper as a co-author — evidently in full knowledge that its fundamental claim was completely false.

    @ cervantes, I agree and have also raised the spectre of Susan Davies’ apparent recantation of her results (also normal) after the Lancet pre-submission meeting with Wakefield et al. More than Wakefield have some explaining to do and hope that a proper inquiry is launched.

  38. #38 Beamup
    November 11, 2011

    Well, rw23′s joke (bad or not) does raise an interesting question. If you kill a different version of yourself from another universe, does that constitute suicide, or murder?

    (I am presuming MWH stands for Multiple Worlds Hypothesis.)

  39. #39 Roadstergal
    November 11, 2011

    Nah, I was just :( in the sense that I cannot contribute substantively to the discussion. No All The Myriad Ways-ing required.

  40. #40 MartinM
    November 11, 2011

    I suggest consulting the popular Jet Li documentary “The One”.

  41. #41 rw23
    November 11, 2011

    @beamup #36:

    Your presumption is correct, although I don’t believe your subsequent question follows entirely. My silly joke (in bad taste to some, I agree) supposes that in one or more related worlds out of 10^500 (or whatever the latest estimate might be) I felt enough shame for my incomplete response to Roadstergal that it would cause me (or at least one of me in those alternate worlds) to commit suicide in an attempt to exonerate the shame of potentially upsetting another person. Understandably (and here I also fell down, as Luna_the_cat rightly pointed out) such a light-hearted reference could also be upsetting to many people.

    I wish I hadn’t started this. However it has been an eye-opener into other people’s lives, regarding what they have to deal with and the way they manage. I apologise for any offence. I much prefer to live and learn.

  42. #42 rw23
    November 11, 2011

    @Roadstergal #37:

    Contribute substantively to the discussion? You made a very reasonable point. As far as UK law goes, I am desperately drawing upon O-Level Economics And Public Affairs lessons I tried to learn in school thirty years ago, buttressed by attempting to stay up with Parliament (in all its shenanigens) since, and by reading decent newspapers and Private Eye whenever affordable.

    Apparently we are all personally responsible if we break the law, even if no-one has ever told us it what it actually says.

  43. #43 Luna_the_cat
    November 11, 2011

    Sorry, too. I try not to be oversensitive to it, especially because suicide is unfortunately still a meme or a gag in a lot of places. It’s just that sometimes I run across it in a place and a way that I don’t expect, and it gets an “urgh” reaction.

    It has been kind of a bad year.

  44. #44 rw23
    November 11, 2011

    @Luna_the_cat #41:

    I can sympathise with that. I think that suicide (or cancer deaths, my current bugbear) is at risk of being minimalised through a throwaway culture which does its best to avoid the topic of death or hope we can all get away with joking about it. However we do it, we deal with our losses and we do our best to get on with our lives.

    Anyway, enough of this depressing shit. Rainbows, autumn leaves, roast chicken! Baby cuttlefish!

  45. #45 palindrom
    November 11, 2011

    Meanwhile, over at the Wretched Hive, another paean to the One Woo to Rule Them All –

    http://www.huffingtonpost.com/larry-malerba/homeopathic-arnica_b_1081164.html

    I’m shocked, shocked that a major internet news site would promulgate such bunk.

  46. #46 rw23
    November 11, 2011

    @palindrom #43:

    Another day, another dollar.

    It’s not like they care that sick people might get sicker, because in their eyes regression to the mean equals cure.

    Out of the dozen or so practices in my adopted home town there are two which employ homeopaths (MDs who willingly advertise their HomPath ‘qualifications’). As a matter of principle I avoid those places, even though one practice is the largest and most convenient for those of us living in the centre of town without personal transport.

  47. #47 rw23
    November 11, 2011

    Oops, I forgot to add ‘bleurghh!’ to the direction of my previous comment.

    Though I’d like to think it goes without saying.

  48. #48 Krebiozen
    November 11, 2011

    I suspect that Wakefield, who seems to be a charismatic and persuasive chap, led Davies, Dhillon, Walker-Smith et al (and possibly himself) into an error that has fooled many intelligent and learned people; that of seeing patterns in noise. If you stare at any noisy data for long enough you can start to see imaginary patterns in it, especially when someone tells what pattern you are looking for. Minor inflammatory changes in the biopsy samples of children with constipation and/or irritable bowel syndrome (or “toddler diarrhoea” as Walker-Smith called it) are ideal noisy data for this.

    I can understand people making this error, but refusing to acknowledge this when it is pointed out to them (I am thinking of Wakefield and Walker-Smith here) is something else.

  49. #49 Pareidolius
    November 11, 2011

    Damn you Palindrom, I went over there and read the article and got sucked into the vortex of stoopid! Ullman is riffing away in the comments. He actually used the argumentum ad populum fallacy with fashion models as his exemplars of the efficacy of arnica montana. Well, I say, what about hannah montana?

  50. #50 Denice Walter
    November 11, 2011

    @ Krebiozen:

    I truly wonder how fellows like Andy could ever believe that they’d get away with it? Personally I know that I’m rather bright but still wouldn’t *dream* that I could possibly fool *everyone*- including experts worldwide: many people are at least *as* bright or, more importantly may see the material in an entirely different light than I do which would render my fraud transparent.

    I think that there is much more than narcisscism here- there must be an inability to “read” and understand others’ capacities and reactions. I wouldn’t be surprised if self-deception was involved as well. Not a pretty picture.

  51. #51 Ross Coe
    November 11, 2011

    This orac, whatever that is ,is some piece of work. No one can better twist information into a pure slant to one side. Once orac is done, theres no recognizing the issue at all. There is simply no other side in these ficticious reports.
    Pure dishonesty at its finest. Say hi to your friends in the Pharmafia for me.

  52. #52 Prometheus
    November 11, 2011

    Blackheart (#2):

    “You see not only do you have to deconstruct an argument you also have to problem solve a solution that fits the requisite evidence.”

    Wrong – to invalidate an argument (such as Dr. Wakefield’s “autistic enterocolitis” claim), all you have to do is show that it is incorrect. There is no requirement to have a “better” explanation.

    This is a common line of fallacious reasoning among “alt-med” supporters and other fantasy-based philosophies. Again, showing that an argument or claim is incorrect is sufficient – there is no need to provide an alternate explanation.

    As this pertains to Dr. Wakefield, we now have evidence showing that his “study” [a] enrolled “subjects” referred by lawyers rather than sequentially, as was stated in their paper; [b] some of the autistic children regressed before receiving the MMR vaccine and some regressed over six months after receiving the vaccine; and now we have [c] even the “specialised” pathologist examining the biopsy slides interpreted them as “normal”.

    What’s left? Are we going to find out that some of the subject weren’t children?

    Prometheus

  53. #53 Krebiozen
    November 11, 2011

    Denice,
    I don’t think we will ever know how much of Wakefield’s behavior was down to self-deception, and how much was a callous quest for glory and financial reward. I suppose it’s possible that he was, and still is, simply certain he was right and this justified, in his mind, what he did. However, the way he set everything up ready to profit from MMR being discredited suggests a lot of premeditation. The fact that he rejected the opportunity to conduct further research at the Royal Free to replicate his results suggests he knew that this would fail. His refusal to defend himself at the GMC hearing is difficult to understand if he believed he had done no wrong. His behavior since his fall from grace, throwing in his lot with some very unsavory people doesn’t show him in a good light. I like to give people the benefit of the doubt, but it’s very hard to do this in regard to Wakefield’s behavior.

  54. #54 Sauceress
    November 11, 2011

    For example, former UPI reporter turned vaccine/autism cran Dan Olmsted has been attacking the BMJ.
    ……..
    Now I know. It’s a preemptive strike.

    BMJ editor-in-chief Dr Fiona Godlee goes one further than Brian Deer in that she asserts that at least six other papers by Wakefield besides the Lancet paper require “independent investigation.” She sent a letter to Andrew Miller MP arguing that Parliament must investigate University College of London, where the research was carried out, unless UCL immediately starts an independent inquiry

    But…But I don’t understand…(:p)

    The constant mantra of the antivaxx congregation has been that Wakefield’s “finding” was genuine and so he is innocent of all charges. So if the antivaxx managers really believe this, shouldn’t they be very loudly celebrating an independent inquiry into all of Wakefields papers?

    *Listens out for the sound of Black Helicopters over at AoA*

  55. #55 Sauceress
    November 11, 2011

    Oh I just can’t resist…

    *in my best attempt at antivaxxer tone*
    What is it that Dan Olmsted is so afraid of?

  56. #56 TGAP Dad
    November 11, 2011

    The phrase “hoist by his own petar[d]” comes immediately to mind. Or how about “I love it when a plan comes together?”

  57. #57 Matthew Cline
    November 11, 2011

    @Sauceress:

    So if the antivaxx managers really believe this, shouldn’t they be very loudly celebrating an independent inquiry into all of Wakefields papers?

    Ah, but an inquiry done by the government won’t be independent, but instead will be controlled by Them, who will twist and fabricate evidence to make it look like Saint Andy did something wrong.

  58. #58 lilady
    November 11, 2011

    I’ve been “slumming” again at AoA and they are actually stating that this latest revelation about the pathology reports is “proof positive” that Brian Deer is part of the conspiracy against St. Andy.

    They have even linked the “Nature” and “Scientific American” websites, so that their devotees can post comments about Deer’s vendetta against Andy. Ann Dachel and John Stone have both posted a number of comments which are “classics”.

    I love AoA for their conspiracy theories and their quality of scientific journalism.

  59. #59 blackheart
    November 12, 2011

    Herr Doktor

    “Diagnosis”? That implies a gut disease to be diagnosed. What part of “overwhelmingly normal” do you not understand?

    Are you implying that three of the world’s leading gastroenterologists do not know what a paediatric gastro disease pathology looks like ?

    You do know that a paeditric disease differs remarkably in physiology to an adult disease didn’t you ?

    You did know that both severe and acute constipation and diarrhea are both implicated in colitis.

    They did see the pathology slides , the patients and the actual colonoscopies.

    This is what science rationalism looks like is it ? Very interesting.

  60. #60 blackheart
    November 12, 2011

    Prometheus

    Wrong – to invalidate an argument (such as Dr. Wakefield’s “autistic enterocolitis” claim), all you have to do is show that it is incorrect. There is no requirement to have a “better” explanation.

    Wrong – In the real world of medicine diagnosis rather than your prejudicial construct of science, it is incumbent on the physician to diagnose and treat the patient. Thus come up with a solution. These are not artificial constructs (You see the factor that gets in the way … humanity).

    [a] enrolled “subjects” referred by lawyers rather than sequentially, as was stated in their paper

    Wrong – Lawyers are unable to ‘refer’ anyone to a medical specialist. The normal pathway is through a registered medical practitioner.

    some of the autistic children regressed before receiving the MMR vaccine and some regressed over six months after receiving the vaccine

    Did they ? I’m supposed to be surprised by that. Do you know nothing of the pathology of diseases and neurodevelopmental disorders and their aetiology. Do all conditions follow the same functional aetiology and timeline.

    One supposes your talking about the child with Otitis Media.

    even the “specialised” pathologist examining the biopsy slides interpreted them as “normal”.

    Wrong – Go and read the actual pathology sheets again.

    —————————————————-

    Guess what I’m going to take the word of one of the world’s leading paeditaric gastroenterologists when he says he saw evidence of …

    “this mucosal abnormality has been apparent in 47/50 children within the autistic spectrum, whether or not there is any perceived link with immunisation. Thus the lymphoid hyperplasia/ microscopic colitis changes were found in over 90% of the autistic children studied. Even if there is no immunodeficiency, the lymphoid hyperplasia in many cases is remarkable, with germinal centres showing higher numbers of proliferating (Ki67 positive) cells than we have detected in any immunodeficient controls with lymphoid hyperplasia. We are very familiar with the detection of lymphoid hyperplasia in children with minor immunodeficiency, as are Lindley and Milla, and have published several reports on this topic. We were thus ideally placed to detect the exaggerated lesion found in many of these children. The colitis itself is variable, but may feature crypt abscesses, increased macrophage infiltration and unregulated class II major histocompatibility complex expression.

    —————————————————–

    What’s left? Are we going to find out that some of the subject weren’t children?

    Well they are not statistics or play things for epidemiologists or journalists with an axe to grind.

    How many times can you be wrong Prometheus.

  61. #61 palindrom
    November 12, 2011

    Pareidolius @47 — Sorry, but you were a consenting adult. I can’t be responsible for your lack of self-discipline. [I kid, I kid.]

    That said, you did leave excellent comments from experience of how ineffectual this stuff is.

    I left one comment which was simply: “6.02 x 10^23″.

    So far, no one’s goat appears to have been gotten by that.

  62. #62 Dangerous Bacon
    November 12, 2011

    “But Dhillon’s reports produced results that pathologists, gastroenterologists, and a gastrointestinal immunologist to whom we have shown them say are overwhelmingly normal and might be found in almost anybody’s gut.

    “Most of this stuff is so close to normal that you’ve really got to question whether there is really anything there,” said Henry Appelman, professor of surgical pathology at the University of Michigan and a specialist in gastrointestinal disease. “These are the kind of things that we in our practise here would ignore completely.”

    Dr. Appelman (a distinguished G.I. pathologist with whose work I am familiar) refers to a common situation in pathology – avoiding misinterpretation of biopsies in which the tissue by its very nature contains lots of inflammatory cells. Everyone posting here (gasp!) has a gut jammed full of lymphocytes, plasma cells, histiocytes, eosinophils, lymphoid aggregates and other inflammatory cells, all busily processing antigens that arrive via our diet, drugs and supplements we take, normal gut flora (and not-so-normal flora) etc. The challenge as a pathologist (I am a general surgical pathologist who sees lots of G.I. biopsies in daily practice) is interpreting abnormal patterns in conjunction with architectural changes, and not being too enthusiastic about assigning pathology to minor changes that can be induced by something as simple as the bowel prep (laxatives) used prior to colonoscopy. Otherwise you wind up diagnosing dubious entities like “mild chronic colitis” and getting people worked up for imaginary inflammatory bowel disease and other conditions.

    If Dhillon’s descriptions of what he saw under the microscope are unconvincing to a highly respected expert in the field like Dr. Appelman, I’d take it as strong evidence that there was nothing of significance to be reported.

    So, just where are those tissue blocks and slides? (the Wakefield debacle and its persistent apologists are sounding more and more like a bad remake of The Fugitive).

  63. #63 lilady
    November 12, 2011

    “So far, no one’s goat appears to have been gotten by that.”

    I just left a bit of snark at Ho-Po…if it gets through, I am sure the good doctor will be responding.

  64. #64 lilady
    November 12, 2011

    “So, just where are those tissue blocks and slides? (the Wakefield debacle and its persistent apologists are sounding more and more like a bad remake of The Fugitive).”

    Good question Dangerous Bacon. I don’t know how Wakefield might have “misplaced” these particular slides, but wouldn’t the fixed-in-paraffin specimens be easily transported out of his laboratory in “someone’s” briefcase? It is my understanding that paraffin blocks are not “regulated medical waste”.

    Perhaps Lord Draconis has a colleague he can consult about such nefarious activities.

  65. #65 Sick sauce
    November 12, 2011

    parliament UK not interested in Godlee’s request = More evidence of the worthlessness of the witch hunt against Dr. Andrew Wakefield’s research.

  66. #66 Gray Falcon
    November 12, 2011

    @65: No it isn’t. Wakefield’s research is still invalid, and he’s still no longer a doctor.

  67. #67 Chris
    November 12, 2011

    Funny how Common Sue (SS) is so enamored with a case series of just twelve kids, but rejects the several large epidemiological studies done on several countries on three continents that covered hundreds and thousand of children.

    She never did have much common sense.

  68. #68 brian
    November 12, 2011

    @Dangerous Bacon

    How long would you, a surgical pathologist, expect the slides and embedded biopsy materials to be maintained from a research effort that produced undoubtedly controversial results that might be expected to have both a profound impact on public health and obvious legal implications?

    I suppose that even if those important materials had been misplaced early on, Wakefield would have been able to replicate them, given that the Royal Free offered him financial and staff support to conduct a study of 150 children. Pity he didn’t do it . . .

    My habit has been to save everything that might be important. Perhaps things were different at the Royal Free.

  69. #69 Antaeus Feldspar
    November 12, 2011
    Wrong – to invalidate an argument (such as Dr. Wakefield’s “autistic enterocolitis” claim), all you have to do is show that it is incorrect. There is no requirement to have a “better” explanation.

    Wrong – In the real world of medicine diagnosis rather than your prejudicial construct of science, it is incumbent on the physician to diagnose and treat the patient. Thus come up with a solution. These are not artificial constructs (You see the factor that gets in the way … humanity).

    So if a physician has no actual answers to give to a parent, the “real”, “human” thing to do is to lie through one’s teeth to the parents and pretend one has the answers? Sorry, but even if we were talking specifically about “what should a physician in Wakefield’s position have told the parents about the cause of their child’s condition” rather than “what would have been the scientific truth of what’s known about the cause of the child’s condition” the answer is still the same, and it isn’t “make up some unproven bullshit called autistic enterocolitis and parlay it into fortune and fame.”

    [a] enrolled “subjects” referred by lawyers rather than sequentially, as was stated in their paper

    Wrong – Lawyers are unable to ‘refer’ anyone to a medical specialist. The normal pathway is through a registered medical practitioner.

    Blackheart is only pointing out how badly Wakefield and his business associates in fact behaved. The fact is that the children went to be examined by Wakefield, not because a registered medical practitioner thought that was an appropriate step for the children’s medical care, but because the lawyers thought that it was a productive step for the lawsuit.

    some of the autistic children regressed before receiving the MMR vaccine and some regressed over six months after receiving the vaccine

    Did they ? I’m supposed to be surprised by that. Do you know nothing of the pathology of diseases and neurodevelopmental disorders and their aetiology. Do all conditions follow the same functional aetiology and timeline.

    In this universe, effects come after causes, not six months before. This applies to all diseases, and in fact to everything except maybe some funky sub-atomic particle stuff. So yeah, if you encounter a claim that a child regressed into autism as a result of something that wouldn’t even happen until half a year later, the honest thing to do would be to be surprised and dubious of the claim.

  70. #70 Offal waste
    November 12, 2011

    @65. It would have been an awful waste of public money, too.

  71. #71 Dangerous Bacon
    November 12, 2011

    The legal minimum requirement in the U.S. for retention of laboratory materials (under the federal Clinical Laboratory Improvement Amendments (CLIA)) is for retention of glass slides and test reports for at least 10 years, and for paraffin tissue blocks to be retained for at least two years (the College of American Pathologists requirement for CAP-accredited labs is to hold onto tissue blocks for at least 10 years). Many labs retain such materials far longer.

    Remember that we’re talking about day-to-day surgical pathology materials for which storage can get expensive and inconvenient in high-volume practices.

    I don’t know what requirements there may be as regards research material in the U.K., but I wouldn’t expect there to be much of a storage problem, and also that as part of good research practice you’d want to hold onto slides and blocks for lengthy periods for possible additional testing (special stains, molecular studies and so on). I don’t see the need to discard them so expeditiously. And yes, since Wakefield’s research was reported to be so groundbreaking and momentous, that’s all the more reason to retain the slides and blocks indefinitely.

  72. #72 Julian Frost
    November 12, 2011

    @Sicksauce:

    parliament UK not interested in Godlee’s request = More evidence of the worthlessness of the witch hunt against Dr. Andrew Wakefield’s research parliament short of money and doesn’t think it worthwhile to investigate years after the fact.

    FTFY.

  73. #73 Julian Frost
    November 12, 2011

    Sorry, I’ll try that again.

    parliament UK not interested in Godlee’s request = More evidence of the worthlessness of the witch hunt against Dr. Andrew Wakefield’s research Parliament short of money and doesn’t think it worthwhile to investigate years after the fact.

  74. #74 Andrew
    November 12, 2011

    parliament UK not interested in Godlee’s request = Why waste money to find even more evidence that Wakefield is a crook when the current evidence would convince anyone who is not profiting from Wakefield’s crimes?

  75. #75 herr doktor bimler
    November 12, 2011

    Are you implying that three of the world’s leading gastroenterologists do not know what a paediatric gastro disease pathology looks like ?

    I see no such implication in my comment. Are you implying that “three of the world’s leading gastroenterologists” did find a “paediatric gastro disease pathology”? These being?

    The gist of the post is that one of the people who examined the samples described them in terms that were “overwhelmingly normal”:

    Dhillon did not find frank enterocolitis in any of the children.

    They were also examined by “consultant histopathologist Susan Davies”, for whom “these specimens were nearly all read as normal”, and who challenged the colitis description; and by a trainee pathologist, Dr Anthony.

    Wakefield describes his own role as “in attendance”, ruling out any personal part in the diagnostic process.

  76. #76 ken
    November 12, 2011

    Brian Deer Strikes Again

    http://briandeer.com/rofecoxib-index.htm

  77. #77 ken
    November 12, 2011

    Brian Deer exposes “Bactrim”

    http://briandeer.com/bactrim-septra.htm

  78. #78 ken
    November 12, 2011

    Brian Deer “exposes” Bactrim

    http://briandeer.com/bactrim-septra.htm

  79. #79 Narad
    November 12, 2011

    Thanks for really putting some effort into it, “ken.”

  80. #80 ken
    November 12, 2011

    @Narad-

    His expose of “Bactrim” is even better.

  81. #81 blackheart
    November 12, 2011

    Antaeus Feldspar

    Thanks for your input I’m sure Prometheus has some ability to talk and write for himself. Though he seems to be a bit tardy at this moment.

    Of course I would not be doing my duty for health and safety if I did not point that your response is filled with substantial errors.

    Perhaps you should go over it again and see where you might have gone wrong.

  82. #82 lilady
    November 12, 2011

    @ Hit and Run: His expose on Wakefield is, IMO, the best.

  83. #83 lilady
    November 12, 2011

    @ Hit and Run: I left a message for you about Diphtheria and some questions for you at the “pox party”…why don’t you answer them?

  84. #84 Krebiozen
    November 12, 2011

    The normal blood tests for inflammation, the normal colonoscopies and normal biopsies in the presence of intestinal symptoms (such as diarrhea, abdominal pain, bloating and food intolerance) are all consistent with a diagnosis of irritable bowel syndrome or toddler’s diarrhea. Professor Walker-Smith had previously diagnosed Child 1 with toddler’s diarrhea. From the GMC Transcripts Day 3 page 62:

    At outpatient appointment was arranged by Professor Walker-Smith in June 1996, and there was a clinical history taken by Professor Walker-Smith which did indeed include gastrointestinal symptoms of undigested food, no control, occasional blood in the stools, and Professor Walker-Smith concluded that the child had the features of a syndrome known as “toddler’s diarrhoea” and that is a well-recognised medical syndrome which affects small children, which does not normally require treatment and normally goes away by the time the child is five or six.

  85. #85 ken
    November 12, 2011

    OOPS- Bactrim still being used.

    No use answering lilady’s questions- she has designated herself as the expert.

  86. #86 Chris
    November 12, 2011

    Ken, did you read this? And do you really have a point in your hit and run comment?

  87. #87 Narad
    November 12, 2011

    And do you really have a point in your hit and run comment?

    I’m certainly having a difficult time ascertaining one. I do have some generic Bactrim somewhere, though, so perhaps that has something to do with it.

  88. #88 ken
    November 12, 2011

    Just getting the facts from all the “experts” here.

  89. #89 Chris
    November 12, 2011

    What facts, be specific and less cryptic.

  90. #90 Chris
    November 12, 2011

    Also, the usual method for someone to get facts from people is to ask questions and not just post random URLs with limited comment..

  91. #91 ken
    November 12, 2011

    @Chris-
    Why haven’t they heeded Brian Deer’s warning about Bactrim-
    (found by accident) I suffer from Attention Deficit Disorder.

  92. #92 Chris
    November 12, 2011

    Who is “they”, and are you using ADD as an excuse for your obtuse cryptic posting style?

  93. #93 Narad
    November 12, 2011

    Oh, now I get it: “ken” is a less competent version of OQF.

  94. #94 blackheart
    November 12, 2011

    Herr Doktor

    I see no such implication in my comment.

    Well that’s not a good sign then. It indicates to me a lack of intellectual rigour in your assessment and response to these matters.

    “Are you implying that “three of the world’s leading gastroenterologists” did find a “paediatric gastro disease pathology”?

    Certainly I thought that was obvious.

    These being?

    “an unusual gastrointestinal abnormality characterised by ileal-lymphoid-nodular hyperplasia and non-specific enterocolitis that is not classical inflammatory bowel disease.”

    “lymphoid hyperplasia/ microscopic colitis changes were found in over 90% of the autistic children studied. Even if there is no immunodeficiency, the lymphoid hyperplasia in many cases is remarkable, with germinal centres showing higher numbers of proliferating (Ki67 positive) cells than we have detected in any immunodeficient controls with lymphoid hyperplasia. We are very familiar with the detection of lymphoid hyperplasia in children with minor immunodeficiency, as are Lindley and Milla, and have published several reports on this topic. We were thus ideally placed to detect the exaggerated lesion found in many of these children. The colitis itself is variable, but may feature crypt abscesses, increased macrophage infiltration and unregulated class II major histocompatibility complex expression.”

    The Lancet – John Walker-Smith

    The gist of the post is that one of the people who examined the samples described them in terms that were “overwhelmingly normal”

    I suppose the first question to which person are you describing ?

    Which was what I was essentially trying to draw out before.

    You do know that a paeditric disease differs remarkably in physiology to an adult disease didn’t you ?

    You did know that both severe and acute constipation and diarrhea are both implicated in colitis ?

    Dhillon did not find frank enterocolitis in any of the children

    When all the physiology and all other patient evidence was collated that team of researchers drew a conclusion of microscopic colitis with lymphoid hyperplasia.

    If you can show me a study pre-dating Walker-Smith’s conclusions that this is a common feature in paediatric gastroenterology please feel free to do so.

    They were also examined by “consultant histopathologist Susan Davies”, for whom “these specimens were nearly all read as normal”

    I do not believe that Susan Davies comes to that conclusion at all and that those words are taken out of context. But feel free to link to the article where she says that so we can all check.

    I’m certainly unsurprised and underwhelmed that skeptiks would cherry pick one data set (not even complete) and try to formulate a conspiracy theory.

    That children were referred by their family doctors and GP’s (with full parental consent) to a paeditaric gastroenterology service for severe and debilitating GI disease of unknown origin and which had not been previously treated effectively.

  95. #95 Krebiozen
    November 12, 2011

    Ken,

    Here’s a little perspective for you.

    Septrin/Bactrim 1.42 deaths for every million prescriptions issued (Committee on the Safety of Medicines). Risk of death = 1 in 704,000.

    Chicken pox in otherwise healthy children aged 1-14 mortality rate is estimated at 2 deaths per 100,000 cases (Medscape Reference). Risk of death = 1 in 50,000

    I figure that parents deliberately infecting their children with “harmless” chicken pox are putting their children at 14 times the risk of death as compared to a patient given Septrin/Bactrim.

  96. #96 ken
    November 12, 2011

    @Krebiozen

    Thank you for the info.

  97. #97 Krebiozen
    November 12, 2011

    Since this thread is about Wakefield and MMR perhaps a comparison between Bactrim and measles would be more relevant.
    Septrin/Bactrim mortality risk = 1 in 704,000
    Measles mortality risk (CDC) = 1 in 1000 (up to 1 in 500)

    Measles is at least 704 times more dangerous than Septrin/Bactrim.

    Measles is also ineffective in the treatment of bacterial infections, whereas Septrin/Bactrim is proving very useful in treating infections caused by organisms resistant to other antibiotics.

  98. #98 lilady
    November 12, 2011

    @ Narad…I forgot about OQF, its references from whale.to and its vicious attacks on Brian Deer. OQF was also quite incoherent…could that be the reasons for the pointless “hit and run” postings. It certainly isn’t ADD.

  99. #99 Antaeus Feldspar
    November 12, 2011

    Thanks for your input I’m sure Prometheus has some ability to talk and write for himself. Though he seems to be a bit tardy at this moment.

    Oh, I know that Prometheus can talk and write for himself. I’m also aware that if you make stupid claims in your comments, anyone can point them out, not just one single person who you might have been responding to.

    Of course I would not be doing my duty for health and safety if I did not point that your response is filled with substantial errors.

    Perhaps you should go over it again and see where you might have gone wrong.

    Perhaps. Or perhaps I’ll observe that talk is cheap and if you can’t back up an accusation of “substantial errors” that endanger “health and safety” it’s your own reputation that suffers. … I mean, assuming it has further down to go after you’re already on record claiming that symptoms manifesting six months before the putative causative agent is a completely normal disease progression.

  100. #100 Chemmomo
    November 12, 2011

    Blackheart,

    You do know that a paeditric disease differs remarkably in physiology to an adult disease didn’t you ?

    Do tell: What details would distinguish a normal child colon from a normal adult colon? Exactly what details would be considered not normal for a child, while normal for an adult?

  101. #101 DLC
    November 12, 2011

    Wacky Wakefield reminds me of many people who achieve celebrity status. He’s gotten a fat head about it, and refuses to sink back into obscurity. Ditto Dan “I can’t find county services clinics” Olmsted. Message for Wacky Wakefield: dude. stand down and fade back into obscurity. Seriously.

  102. #102 brian
    November 12, 2011

    @Dangerous Bacon,

    Thanks for your reply.

    The current guidance from the Royal College of Pathologists (The retention and storage of pathological records and archives) includes this information regarding the retention of the sort of pathology materials that were lost from the studies Wakefield published in 1998:

    Paraffin blocks
    77. At least 30 years if storage facilities permit. If not, select representative blocks, showing main pathology, for permanent retention and review the need for archiving at ten years and at intervals thereafter.
    79. Early destruction of blocks from paediatric cases is inappropriate; these should not be destroyed until the child is at least 25 years old.

    Stained slides
    91. Appropriate retention times depend on their purpose
    Histology: ten years; longer if practicable. It should be realised that retention of the paraffin block alone does not always guarantee the retention of relevant diagnostic material, especially with small biopsies. If the disposal of slides at ten years is contemplated, it may be appropriate to select slides from small biopsies for longer retention.

    The guidance also includes discussion regarding the necessity of retaining pathology material and related documentation “if there is a reasonable expectation that [legal proceedings] are about to commence”, in which case destruction of “documents or specimens relevant to that matter” should be halted.

    It’s strange that the pathology materials related to the pediatric cases discussed in the Lancet paper went missing.

  103. #103 herr doktor bimler
    November 12, 2011

    your response is filled with substantial errors.
    Perhaps you should go over it again and see where you might have gone wrong.

    Blackheart has a rather cryptic commenting style that expects other commenters to provide both sides of the argument… they have to deduce what point he or she is making, as well as form their own response to it. I am reluctant to get involved in this form of dialog for fear that I am deducing the wrong point, in which case I would be wasting my time trying to respond, and I’m sure Blackheart doesn’t want that.

    Blackheart @59:
    Are you implying that three of the world’s leading gastroenterologists do not know what a paediatric gastro disease pathology looks like ?

    I am still wondering how to read such an implication into my own comment at #26. Imprimus, the only three experts involved were hardly “world’s leading gastroenterologists”, with one of them being a student, while a second (Dhillon) was at the time the hospital’s senior pathologist with no particular professional honours. Secundus, far from criticising their evaluations, I was in fact quoting a summary (from an outside authority) of one of those experts’ actual observations. Tertius, no-one is in a position to criticise those experts’ evaluations, because the original biopsies are not currently on hand, in a lapse of ethics and professional competence on someone’s part.

    Blackheart is not so much reading between the lines of my comment to see implications that aren’t there, but reading a completely different page, in a completely different book, in a foreign language. Possibly the Voynich Manuscript.

  104. #104 Chris
    November 13, 2011

    herr doktor bimler:

    Blackheart has a rather cryptic commenting style that expects other commenters to provide both sides of the argument… they have to deduce what point he or she is making, as well as form their own response to it.

    A mark of true troll. Though it is not your normal troll, the obtuse cryptic troll.

    Blackheart is not so much reading between the lines of my comment to see implications that aren’t there, but reading a completely different page, in a completely different book, in a foreign language. Possibly the Voynich Manuscript.

    That is because he is ThingyJr, and also lives on Htrae. For all we know he and Thingy are conjoined twins living in separate countries.

  105. #105 herr doktor bimler
    November 13, 2011

    Has anyone popped up at AoA complaining about Brian Deer’s theft and misuse of Dr Dhillon’s intellectual property, i.e. his histological scoring sheets? I figure it is only a matter of time.

  106. #106 blackheart
    November 13, 2011

    Chris

    That is because he is ThingyJr, and also lives on Htrae

    With the coding skills you just displayed I’d imagine the Voynich Manuscript will be out of your league for some considerable time.

    Herr Doktor

    Has anyone popped up at AoA complaining about Brian Deer’s theft and misuse of Dr Dhillon’s intellectual property…

    1. I’d be most surprised if anyone other than the pathology department had access to requisite slides etc
    The most reasonable explanation is that they are filed somewhere rather than ‘lost’ or ‘stolen’. Nice conspiracy theory though.

    2. That would be Professor Dhillon.

    3. The (intellectual?) property resides with the institution formerly Royal Free Hospital now University College London Partners. Of course intellectual property also resides with one’s employers a source of some consternation for skeptiks trying to envisage that Andy Wakefield were going to make money out of ‘transfer factors’.

    You do see the difference between intellectual and actual property ?

  107. #107 lilady
    November 13, 2011

    Yes Doktor Bimler…I slum over at AoA frequently and they have been discussing the paper reports that Brian Deer revealed recently. They were off and running about medical records violation, but then someone posted how Deer got the lab papers. They are also discussing BMJ Editor Fiona Godlee who is part of “the conspiracy” to get Wakefield.

    It is all part of “the conspiracy” that has been revealed by some of their “journalists” in an extensive 8 part series. So utterly confusing and confounding to me; I cannot keep track of the “good guys” and the “bad guys”.

    I tried keeping a scorecard and found that everyone is in on “the conspiracy” to “get Wakefield” according to their twisted and convoluted thinking processes.

    Apparently in their minds, everyone is paid off by Big Pharma, including the doctors who attended the GMC hearing and made the recommendation to strike Andy from the registry and government officials. They even have implicated Anderson Cooper, a TV journalist who interviewed Andy in January, then Deer the following night…now pilloried by AoA because the interviews did not put Andy in a good light.

    Of course, earning their special derision are Orac and the regulars here.

    BTW, where is Jake? I wanted to ask him a few questions about his trip with his parents to Texas for the fundraiser for the Autism Trust-USA. I have my own conspiracy theory, that the Autism Trust-USA either already has Andy on the payroll, or will hire him shortly as their Executive Director.

  108. #108 herr doktor bimler
    November 13, 2011

    they have been discussing the paper reports that Brian Deer revealed recently.

    What could possibly be wrong with Wakefield holding custody of Dhillon’s work for all this time? And what could possibly be the downside of calling attention to it?

  109. #109 Brian Deer
    November 13, 2011

    @brian

    Yes, the paraffin blocks are said to exist. But there’s a snag. One would need ethical approval to report on them, and, I would imagine, permission from the patients or their guardians.

    There was a particularly sickening moment in all this a couple of years back during Wakefield’s GMC. Outside the building a gang of his acolytes turned up, including one woman who brought a huge poster of her son, who’d had a big piece of his colon chopped out. He looked awful. He’d appeared in media previously, having been seen at a different hospital, not part of the Wakefield research, and diagosed with a severe food intolerance. But Wakefield’s people – being what they are – pretended that he was one of the Lancet children, and that therefore I was a liar when I said that the patients in the study didn’t have IBD. The deceitful representation of that boy even appeared again on Olmsted’s blog just a few days ago in another billious tirade against me.

    So, obviously, it has been important to me that, thanks to the surfacing of the histopathology raw data which the BMJ has now published, I’ve been wholly vindicated. Again.

    Over the years, there have been several efforts to get data on Wakefield’s subjects into the public domain. Previously central was that compiled by an Irish pathologist and Wakefield business partner who claimed to find measles virus in the children. But it wasn’t him, or the parents who wanted this pivotal data released. It was the drug companies and the department of justice. On each point, parents – particularly one, who was found to have no legitimate legal claim against anybody – turned up in London courts to object to the release of what was supposed to be the ultimate evidence that MMR causes autism and bowel disease.

    So you would think, now, that they would want the paraffin blocks released and independent analyses to be done. And you would think wrong.

  110. #110 Grant
    November 13, 2011

    @96 Krebiozen,

    Measles mortality risk (CDC) = 1 in 1000 (up to 1 in 500)

    Do you have a source for that 1 in 1000 mortality risk in measles?

    An ‘concerned person’ (read: anti-vaccine type playing concern trolling) over our way (sciblogs.co.nz) has been asking after the exact same statistic… (I’m flat out coding and am short on time, hence the lazy question!)

  111. #111 Chris
    November 13, 2011

    J Infect Dis. 2004 May 1;189 Suppl 1:S69-77.
    Acute measles mortality in the United States, 1987-2002.
    Gindler J, Tinker S, Markowitz L, Atkinson W, Dales L, Papania MJ.
    National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

  112. #112 Stuartg
    November 13, 2011

    Brian @68

    (Apologies for the delay, and apologies to anyone commenting similarly that I haven’t yet read)

    I recall, as a holiday job about 1980, repackaging paraffin mounted pathological specimens from the 1880s. This was to ensure continuing safe storage.

    I’ve also requested, and received, reports from recut and newly stained biopsies preserved in paraffin that were 40 years old.

    How did Wakefield “lose” specimens that were only a few years old?

  113. #113 Grant
    November 13, 2011

    @109, Chris: Thank you! – will pass it on.

    @110, Stuartg: I recall an earlier comment suggesting that the blocks exist but need to patient/parent permission to be used.

  114. #114 Krebiozen
    November 13, 2011

    Grant,
    I found the measles mortality here but Chris has found the original source – thanks Chris.

  115. #115 Denice Walter
    November 13, 2011

    About the continuing support for AJW, despite mounting evidence to the contrary-

    Cautiously putting on my psychologist’s hat**, I realise that what *we* hold as factual, reality-based, and significant ( sometimes even statistically so) will not hold any water for the anti-vaxx die-hards. Frequently I predict that what makes perfect sense to me will either be a huge stumbling block for them or become select material for future confabulation. They’ve already made their minds up: their constructs are impermeable. I personally tried to get young Jake to question his conspirational mode of thought: I was called awful names and both my education and sources of income were questioned. Sounds familiar, doesn’t it?

    So why is this ? I suspect that the axe-grinders’ issues are intimately woven into their own self-identity and reflect level of functioning: for parents it explains how their child was “damaged” casting aspersion anywhere but on genetic “imperfection” as well as being a means for venting ( and seeking sympathetic camaraderie) about the real difficulties involved in caring for a disabled child. Additionally it is an avenue to fame and fortune inaccessible by other more prosaic means ( for both leaders and followers)
    I won’t talk about the cognitive and emotional differences I suspect but I *do* believe that a few exist and may be measurable (hint: executive functioning).

    For a more general audience, the mounting evidence solidifies mistrust of the entire movement- new information contributes to the growth of that audience and further distances the movement from serious consideration by the general public. It’s like tennis: you go for the shot most likely to succeed in most situations with most people ( “most likely” because it’s substantial) always knowing that a cheater may get a point on you now and then but in the long run you’ll win.

    ** Disclaimer: all analyses of either people or stocks by myself are purely speculative.

  116. #116 Dangerous Bacon
    November 13, 2011

    Brian Deer said: “Yes, the paraffin blocks are said to exist. But there’s a snag. One would need ethical approval to report on them, and, I would imagine, permission from the patients or their guardians.”

    If that’s the case, the U.K. appears to differ substantially from the U.S. as regards legal ownership of tissue involved in research. A recent paper in a pathology journal notes that:

    “In legal disputes concerning the research use of excised tissues, courts consistently have rejected the idea that patients are the owners of their excised tissues or retain any property rights. While only three cases have been adjudicated to date, the findings (in both state and federal courts) have been consistent: patients do not have individual ownership, retain property rights, or have complete control over research use of their excised tissues.9,13 These three cases involved tissues taken specifically for research”

    ht_p://labmed.ascpjournals.org/content/40/2/69.full

    Have there been court decisions in the U.K. finding that patients have ultimate control over their tissues designated for research, whether or not they were later used for development of a commercial product?

  117. #117 Denice Walter
    November 13, 2011

    @ Dangerous Bacon:
    ( I have a long comment in moderation about “acceptance of evidence” by the anti-vaxx set)
    If the blocks exist, show up, are approved and permission is granted, – let’s even say that truly independent *education and training* about the grading system are provided for adamant anti-vaxxers so that they can interpret the data; let’s even buy them microscopes- it won’t make any difference to that crowd.

  118. #118 brian
    November 13, 2011

    A recent paper demonstrated how this controversy could be put to rest: Distribute slides made from the original Lancet blocks and slides prepared from unaffected controls (e.g., biopsy materials from children with chronic constipation but without ASD) to qualified experts in a blinded fashion.

    In this paper, samples from controls and affected individuals were sent to experts who “at the time were totally unaware of the autism literature, unaware of the purpose of the study, and we coded and randomly mixed all slides. Everything sent was coded, blinded, and even blinded to the literature of the purpose of the study.”

    http://jama.ama-assn.org/content/306/18/2001.abstract

    I’m surprised that Wakefield and his supporters have not demanded this proof. Of course, I was also surprised that Wakefield didn’t jump at the chance to extend his study to include 150 children given the offer of salary and research support extended by his employers, because, you know, that should have, um, proved him right, if he was right.

  119. #119 Prometheus
    November 13, 2011

    Blackheart (#81):

    “…I’m sure Prometheus has some ability to talk and write for himself. Though he seems to be a bit tardy at this moment.”

    Sorry to have left you unattended for so long, Blackheart, but I have this thing called a “job” that I must, alas, spend some time attending to, not to mention a “family” and “friends” (you should be able to find explanations of all these terms on-line). Fortunately, there are others, such as the kind Master Feldspar, who can provide instruction and direction for you in my absence.

    Though I hate to admit it, I don’t always read Blackheart’s comments because, having teen-age children of my own, I often have little tolerance for extra-familial adolescent delusions of superiority. Perhaps, Blackheart, if you could provide some substance for your assertions… a little data to ballast your arguments.

    In short, more matter and less posing.

    Would that be too much to ask?

    Prometheus

  120. #120 herr doktor bimler
    November 13, 2011

    Blackheart @94:
    “Are you implying that “three of the world’s leading gastroenterologists” did find a “paediatric gastro disease pathology? These being? “

    The grammar of my question — originally in comment #75 — seems straightforward enough. I was not asking for the nature of a purported disease pathology (which would take a singular pronoun); I asked for the identities of the three “world’s leading gastroenterologists” who purportedly examined the samples and found a disease pathology (hence the plural pronoun). I asked the same question at #103. In the meantime, your response at #102 misses the point entirely. Or the point missed you.

    The gist of the post is that one of the people who examined the samples described them in terms that were “overwhelmingly normal”
    I suppose the first question to which person are you describing ?

    Your question needs a verb to become grammatical, but the person I am quoting is named in the second half of my question, which you have omitted above.
    ——————————————
    Blackheart at #107:
    Has anyone popped up at AoA complaining about Brian Deer’s theft and misuse of Dr Dhillon’s intellectual property…
    1. I’d be most surprised if anyone other than the pathology department had access to requisite slides etc
    The most reasonable explanation is that they are filed somewhere rather than ‘lost’ or ‘stolen’. Nice conspiracy theory though.

    My question at #106 was about the coding sheets (as specified in the second half of the sentence, which you have replaced with ellipses), these being the subject of the original post. Your response misses the point again, being all about pathology slides and blocks. You somehow impute to me a conspiracy theory that these specimens have been “lost” or “stolen”, which would be more relevant if I had mentioned them at all.

    You do see the difference between intellectual and actual property ?

    You did notice that my question was not about the actual IP status of the response forms, but about what commenters at AoA are choosing to believe about their ownership? Going on lilady’s response at #108, they might be the ones in need of your explanation of IP law.

    You are going to so much trouble to miss points that I’m wondering if you were traumatised by one as a child.

  121. #121 Matthew Cline
    November 13, 2011

    @brian:

    Of course, I was also surprised that Wakefield didn’t jump at the chance to extend his study to include 150 children given the offer of salary and research support extended by his employers, because, you know, that should have, um, proved him right, if he was right.

    He claimed that he didn’t do it because those who offered the funding (the Royal Free Hospital) would have somehow restricted his academic freedom, but I strongly suspect that “Royal Free would have restricted his academic freedom” really meant “Royal Free would have watched me like a hawk to the whole time to make sure I couldn’t pull of any chicanery”.

  122. #122 Chris
    November 13, 2011

    Brian:

    Of course, I was also surprised that Wakefield didn’t jump at the chance to extend his study to include 150 children given the offer of salary and research support extended by his employers, because, you know, that should have, um, proved him right, if he was right.

    It has been speculated that Wakefield realized that he could not maintain the fraud with a large study. Oddly enough, one of his more unhinged supporters made this claim: However, the case series is often considered to be hypothesis generating: this may be why at the end of their [retracted] paper, Wakefield et al stated,… snip… “Further investigations are needed to examine this syndrome and its possible relation to this vaccine.”

    I’m waiting for him to tell us why Wakefield did not take of the Royal Free’s offer. I am sure his answer will be similar to the non-answers I get to why the rate of measles declined by 90% between 1960 and 1970 in the USA.

  123. #123 lilady
    November 13, 2011

    @ herr doktor bimler: Here are some of the recent remarks posted at AoA, prompted by this latest yellow journalism, now directed at Fiona Godlee:

    “Desperate British Medical Journal Goodlee Turns on Wakefield’s Co-Authors – John Stone, November 10, 2011″

    “I really don’t understand why Brain Deer is not being investigated and scrutinized? How come he can look at closed medical records, don’t they have HIPPA there? So funny because Paul Offit had an obscure medline on how his vaccine could cause hyperplasia as well? What the hell is going on? Science today is bought and paid for, period.

    Posted by: kathy blanco | November 10, 2011 at 11:15 AM”

    “well Jenny i think it is quite obvious why this is all being dragged up again , Professor Walker-Smith is about to start to fight for his reputation which in my view should not be in question ,

    Posted by: Debra | November 10, 2011 at 09:00 AM”

    Blackheart has been posting at RI for months now and seems to have some inside track with Wakefield and Walker-Smith. Why doesn’t he speak to them and their lawyers to facilitate the release of the slides and paraffin blocks? We could get this all settled quickly, if the parties involved would put in motion the release of these specimens.

  124. #124 Lurker
    November 13, 2011

    @Denise @115-
    You are just as guilty with your closed-minded and polarizing approach to
    vaccination- either you are for – therefore you show high level executive functioning or against- as in Science Mom’s decision that non-vaxers are delusional and a
    menace to society. This is your brilliant “objective” thinking?- wonderful-I doubt your “objectivity” and ability to separate your ego from your “psychological” analysis-
    I will remain a “fence” sitter I am now 60% anti-40% pro- vax and defend my right
    to review all evidence “objectively”. For both sides this has become a religion that
    borders on the fanatical. Saying this is a “complex” subject is an understatement.
    And yes it really does appear that Wakefield botched up (but then again my father
    died from a medical error and decision by a physician-( later discovered-we were medically naive) but I don’t go around with a torch looking to burn MD’s or join in
    Witch Hunts.

  125. #125 lilady
    November 13, 2011

    @ Lurker: Denice and other posters here have looked objectively at the science behind vaccines to prevent childhood and adult diseases.

    I really doubt that you have the educational background to understand immunology and the consequences to the individual and to society if we don’t maintain high herd immunity. We have certainly discussed these issues repeatedly on this website.

    And, if after all this time “lurking” you have certain “reservations”, I think it is useless to discuss your bizarre 60/40 anti/pro stand on vaccines.

  126. #126 Lurker
    November 13, 2011

    @Denice@115
    realized what set me off to come “out”- your term genetic “imperfection”
    I read that again- how elitist that sounds! ie.those that are “autistic”
    are genetically “imperfect”?

  127. #127 Lawrence
    November 13, 2011

    @lurker – you definitely misinterpreted what was said in #115. If you were a true lurker here, you’d know that some of the posters are themselves autistic & we have nothing but the utmost respect for those either on the spectrum or the families that have autistic members.

    What sets us off are those people that attempt to overrule scientific evidence with pure emotion – which is all the anti-vaccine / autism-vaccine link people have left, since Wakefield was exposed & all subsequent research has invalidated any link between autism & vaccines.

    Instead, we end up having the deal with disease outbreaks that shouldn’t be occuring in this time of advances in medical technology. Again, that’s what generates anger – anger that children have to suffer because their parents are listening to cranks.

  128. #128 Denice Walter
    November 13, 2011

    @ Lurker : first of all, thanks for coming out. I’ll do this one step at a time:

    When I speak of executive function and formal ops, I am speaking of a *set* of abilities that develop throughout adolescence and early adulthood that vary in a *standard* fashion across populations: these skills are diverse- from capacities for taking the role of the other, recursive thought, reciprocity to less socially-oriented knowledge of combinational possibilities, hypothetical thought, metacognition, gradations of meanings ( contra black-and-white), abstract thought, metaphor, sarcasm, and evaluation of self and other’s abilities. They measure many skills that are inter-related but not in one-to-one correspondence- people have strengths and weaknesses in their *individual* skill sets.

    Think of a bell curve – the mid-point has the most people, the extremes the least. When I speak of adamant anti-vaxxers I am of course referring to the extremes not people in the middle, e.g. 60/40. There are shades of grey in addition to black and white. Speaking about “imperfection”: notice the quotation marks. I believe I have heard the term “vaccine damaged” and how children were “better” before the vaccine that “harmed” them. I also believe that for extreme anti-vaxxers, the idea of genetic causation is anathema. ( continued)

  129. #129 lilady
    November 13, 2011

    I posted this a while back on RI. I think it gives an excellent overview of the mindset of anti-vaccine bloggers and the people who believe them:

    NEJM January 13, 2011 Perspective-The Age Old Struggle Against the Antivaccinationists, Gregory A. Poland, M.D. and Robert M. Jacobson, M.D.

    “Today, the spectrum of antivaccinationists ranges from people who are simply ignorant about science (or “innumerate” — unable to understand and incorporate concepts of risk and probability into science-grounded decision making) to a radical fringe element who use deliberate mistruths, intimidation, falsified data, and threats of violence in efforts to prevent the use of vaccines and to silence critics. Antivaccinationists tend toward complete mistrust of government and manufacturers, conspiratorial thinking, denialism, low cognitive complexity in thinking patterns, reasoning flaws, and a habit of substituting emotional anecdotes for data. Their efforts have had disruptive and costly effects, including damage to individual and community well-being from outbreaks of previously controlled diseases, withdrawal of vaccine manufacturers from the market, compromising of national security (in the case of anthrax and smallpox vaccines), and lost productivity.”

  130. #130 Igor
    November 13, 2011

    @lurker: So you read that again taking into account the role that quotation marks play in modifying the term “imperfections” in Denice’s post and you still think that it sounds elitist? Yet those on the anti-vaxx spectrum who consider a child with an ASD a fate worse than death has no negative undertones for you? Where’s that fence on which you are sitting, dividing anti-vaccination activists and germ theory denialists?

  131. #131 Denice Walter
    November 13, 2011

    continuing my response to lurker – the first part’s in moderation-

    Notice I say “die hards” and mention a *specific* person who resides amongst them @ AoA. It is common for writers at that outlet to focus primarily on external causation like vaccines. Yet most research today points to a genetic factor and even specific genes ( e.g. 22). The term “autism” refers to specific *deficiencies* in communication and social skills.

    I hypothesise that extreme anti-vaxxers probably have skills that differ from the mean and that they are also using their belief in AJW’s work as a method of coping with a very difficult daily life as care-takers and perhaps as a way to raise their own self-esteem by externalising “blame”. A few even become leaders in the movement and sell books thus gaining social power as well as monetary reward.

    No one @ RI supports vaccines for *every* person or believes that vaccines have no risks at all or are perfect. Again we look upon what is *most* likely: vaccines prevent illness, there are few risks, autism probably begins pre-natally and has a strong genetic component. Please re-read what I wrote and keep in mind that I refer to bell-curves, frequency distributions, means vs extremes, what is “most likely”, and data we already have.

    I hope that these comments clarify my meaning. Please pardon me, I have guests. Have a nice evening.

  132. #132 lilady
    November 13, 2011

    @ lurker: If you have lurked here for any length of time, you would realize that you insulted one of our most esteemed posters here.

    I can only reiterate what other poster have stated about your insults…and request that you apologize to Denice Walter.

  133. #133 Igor
    November 13, 2011

    It is possible that our lurker meant to write “lurker” but figured that people could figure out his ironic use of the term without the confusing quotation marks. If anyone beat me to this realization, my apologies, I did not want to read all the previous posts.

  134. #134 Mrs. Woo
    November 13, 2011

    @Lurker – you’ve riled me up now.

    What is so wrong about “genetic imperfections?” If you have Huntington’s, Parkinson’s, spinocerebellar ataxia (there are many of those), Friedrich’s ataxia, cystic fibrosis, OPCA, schizophrenia, bipolar disorder, some types of depression, etc., etc., you have a genetic imperfection.

    How is it an insult to suggest an illness is caused due to a genetic abnormality? Things happen. Inheritance happens. This does not make the patient a bad person. It just means that the wrong genes happened to be in the sperm and ova that happened to meet up that day.

    Is it somehow an insult to have a genetic illness? Are you suggesting that those who have them are bad people or inferior somehow?

    I don’t understand why people find it offensive to possibly have a genetic cause of illness. A genetic illness is just as big a deal (as far as making you what you are) as having blue eyes instead of green ones. Who you are is not determined by what obstacles you face but rather by the person you choose to become when you face them.

  135. #135 Mrs. Woo
    November 13, 2011

    I might be jumping to conclusions, but I think Lurker is reading into those quotation marks because they find a possible genetic cause of autism to be offensive… my apologies if I have, but I get exasperated that people find the idea of genetic illnesses to be somehow worse than other possible causes.

  136. #136 blackheart
    November 14, 2011

    Herr Doktor

    Blackheart @94

    Or the point missed you.

    Often I give multilayered or multidimensional answers that expand not only on the questions asked but those “not” asked ie implied or alternatively I feel would expand on the topic. I’m that sort of fellow.

    Sometimes I assume that the person I am conversing with and the wider audience, to which I always take into consideration, have a range of knowledge on the particular topic. I assumed yours was quite deep.

    In this case I answered both your direct question (Who were the three GI’s) and expanded on it with further (Pathology) information.

    By quoting directly from evidence widely known and appreciated by any with a depth of knowledge in this debate, I was able to strengthen my already robust case.

    Blackheart 105

    Your response misses the point again, being all about pathology slides and blocks

    See above for a fuller explanation on multilayered and multiaudience.

    Of Note

    etc (something you may have missed as in “had access to requisite slides etc”)

    See how that answer incorporated so many dimensions. You do see , don’t you ?

    You did notice that my question was not about the actual IP status of the response forms, but about what commenters at AoA are choosing to believe about their ownership?

    I did. It’s that multidimensional aspect again getting in the way of your understanding.

    1. I supported rational reasoning and even the adulated one. (That was nice of me)

    2. I corrected a error.

    3. I was able to give the common reader and yourself a greater understanding on property law.

    You are going to so much trouble to miss points that I’m wondering if you were traumatised by one as a child.

    It is difficult to frame one’s answers at the correct intellectual ability. Obviously I had thought you a person who, can throw around some Latin and has a mind for paranormal trivia, was one who might rise to the challenge of intellectual discourse.

    A true man of honor feels humbled himself when he cannot help humbling others.

    Robert E. Lee

  137. #137 blackheart
    November 14, 2011

    Herr Doktor

    Blackheart @94

    Or the point missed you.

    Often I give multilayered or multidimensional answers that expand not only on the questions asked but those “not” asked ie implied or alternatively I feel would expand on the topic. I’m that sort of fellow.

    Sometimes I assume that the person I am conversing with and the wider audience, to which I always take into consideration, have a range of knowledge on the particular topic. I assumed yours was quite deep.

    In this case I answered both your direct question (Who were the three GI’s) and expanded on it with further (Pathology) information.

    By quoting directly from evidence widely known and appreciated by any with a depth of knowledge in this debate, I was able to strengthen my already robust case.

    Blackheart 105

    Your response misses the point again, being all about pathology slides and blocks

    See above for a fuller explanation on multilayered and multiaudience.

    Of Note

    etc (something you may have missed as in “had access to requisite slides etc”)

    See how that answer incorporated so many dimensions. You do see , don’t you ?

    You did notice that my question was not about the actual IP status of the response forms, but about what commenters at AoA are choosing to believe about their ownership?

    I did. It’s that multidimensional aspect again getting in the way of your understanding.

    1. I supported rational reasoning and even the adulated one. (That was nice of me)

    2. I corrected a error.

    3. I was able to give the common reader and yourself a greater understanding on property law.

    You are going to so much trouble to miss points that I’m wondering if you were traumatised by one as a child.

    It is difficult to frame one’s answers at the correct intellectual ability. Obviously I had thought you a person who, can throw around some Latin and has a mind for paranormal trivia, was one who might rise to the challenge of intellectual discourse.

    A true man of honor feels humbled himself when he cannot help humbling others.

    Robert E. Lee

  138. #138 blackheart
    November 14, 2011

    Prometheus

    My apologies.

    Over to you and Master Feldspar. Who am I to hold back the tide of ignorance that surely must flow whence skeptik minds come together.

  139. #139 lurker
    November 14, 2011

    @Mrs. Woo-
    Perhaps those quite possible genetic “factors” could be held in mind before
    implementing the current schedule of 49 doses of 14 vaccines before the age
    of 6.
    Mandating the current vaccine schedule w/o adequate research is polarizing
    too many parents and causing parents to choose not to vaccinate (according to
    what I have read.)

  140. #140 Narad
    November 14, 2011

    Mandating the current vaccine schedule w/o adequate research is polarizing too many parents and causing parents to choose not to vaccinate (according to what I have read.)

    Define “adequate research.”

  141. #141 lurker
    November 14, 2011

    @narad-
    the reason for the increase since my daughter’s vaccine schedule in 1991 proved
    adequate.

  142. #142 Narad
    November 14, 2011

    the reason for the increase since my daughter’s vaccine schedule in 1991 proved adequate.

    Beg pardon?

  143. #143 lilady
    November 14, 2011

    Which of the current vaccines do you consider not necessary?

    Please provide us with specifics and citations. Or, have you just made an uneducated guess?

  144. #144 Igor
    November 14, 2011

    “the reason for the increase since my daughter’s vaccine schedule in 1991 proved adequate.”

    The reasonms for the increase post 1991 are delineated here along with references to the studies testing the safety of multiple administration of various vaccines. The reasons and studies for subsequent changes and studies supporting them (among which MMR was condensed into a single dose) are set forth at length What do you find unconvincing and why.

    I had a gut feeling on many issues proven wrong after some basic critical inquiry. What indication do you have that the current schedule is somehow more of a hazard and what is the perceived danger? What kind of study or studies are you looking and how many that will sway your mind?

  145. #145 Igor
    November 14, 2011
  146. #146 lilady
    November 14, 2011

    @ Igor: The CDC publishes its recommendations for immunizations every year. See:

    2011 Child and Adolescent Immunization Schedule

    I think it is up to “lurker” to provide information…after making that statement.

  147. #147 Militant Agnostic
    November 14, 2011

    Lurker’s argument that the 1991 vaccination schedule his daughter received was adequate is like me arguing that there is no benefit to airbags, all wheel drive, anti-lock brakes or other modern safety features because I haven’t been killed or injured yet in my 1990 Volvo.

  148. #148 ChemoMan
    November 14, 2011

    Thanks lilady for the link ;)

    Wow that’s a pretty hefty schedule 8) I must be getting old ;)
    While I understand the risk analysis for this schedule I actually think that lurker may have a point in that the sheer number of vaccinations scares the crap out of all the science challenged people in the general population, after we are dealing with people who think a youtube video is a citation.

    Lurker I am unsure of your troll status specifically whether you are one or not. Would you care to elaborate on your statement you are 60% anti and 40% pro vax ?

    Cheers

  149. #149 Igor
    November 14, 2011

    @lilady: Thanks. I was aware of the CDC’s immunization schedule’s frequent publication and was merely attempting to provide something close to the change in immunization schedule in the early 1991. Of course your posts suggest that you are still much more knowledgeable about the specifics than I am. Unfortunately, at 2 am I was only willing to do a cursory search driven by my sudden desire to give lurker the benefit of the doubt rather than to recognize the basic anti-vax talking fallacies and dismiss Lurker as uninterested in an intellectually honest discussion. After all, there was a time I unconditionally believed in all sorts of nonsense. Probably still do lest someone point the error of my ways.

  150. #150 dt
    November 14, 2011

    @Blackheart #106

    I did notice you raised the strawman of Wakefield’s “transfer factor” while discussing IP issues, and ask how we envisage Wakefield was going to make any money out of it.

    Well, perhaps you had better ask him, since the GMC found in 2010 that it was “admitted and proved” that Wakefield was involved in a proposal to set up a company called Immunospecifics Biotechnologies Ltd to specialise in the production, formulation and sale of Transfer Factor. The proposed MD of the company was the father of “Child 10″, with Wakefield as research director.

    Let me guess – next you are going to claim that profits from any revenue from this venture would not have gone into Wakefield’s pockets, but into a charitable fund to compensate the innocent child victims damaged by the unnecessary and unethical endoscopic biposies his team performed?

  151. #151 hoary puccoon
    November 14, 2011

    Blackheart @ 137, Reader’s Digest Condensed Version–

    “If you can’t dazzle ‘em with brilliance, baffle ‘em with bullshit.”

    If I had any doubts that Wakefield is a con artist, Blackheart’s so-called defense removed them all. Nobody talks around in circles like that unless he’s trying to pull a fast one.

  152. #152 blackheart
    November 14, 2011

    dt

    Well, perhaps you had better ask him, since the GMC found in 2010 that it was “admitted and proved” that Wakefield was involved in a proposal to set up a company called Immunospecifics Biotechnologies Ltd to specialise in the production, formulation and sale of Transfer Factor.

    You don’t understand Intellectual Property rights then do you ? Especially when you are contracted by an employer. What ‘skeptiks’ overlook intentionally or not through ignorance, is that Royal Free had all rights.

    So for the ‘conspiracy’ to work the Dean and the governing board of the Royal Free Hospital would have to have been part of a wider conspiracy.

    It would then have had to pass all the checks and balances of the drug safety protocols which are quite stringent and of course efficacy examination as well.

    Thanks for your input I always like the opportunity in punching big holes in ‘skeptik’ arguments.

    It’s probably why I haven’t been invited to a skeptik night at the pub recently. Oh well their loss.

  153. #153 lilady
    November 14, 2011

    @ Igor: I doubt that you still believe in nonsense…way too intelligent for any of that. I bet there are others here who survived early childhood by having the actual diseases of early childhood…sadly many kids didn’t.

    @ dt: A slight correction to your excellent post. Wakefield set up two offshore (Ireland) corporations…Immunospecifics Bioltechnologies Ltd. & Carmel Healthcare Ltd. ***”Carmel” Healthcare Ltd. was named after Dr. Carmel Wakefield, his wife. He also set a goal to, once these corporations were fully operational, for them to have yearly gross receipts of $ 43 million from marketing kits to diagnose “autistic enterocolitis”…they would get referrals from lawyers suing vaccine manufacturers. I think one of these offshore corporation was supposed to be marketing the single antigen measles vaccine being developed by Wakefield…once his 12-child “study” was accepted in the wider science community and by parents.

    ***Carmel Wakefield sits on the Board of Directors of Autism Trust USA and is the Executive Secretary of the Autism Trust USA National Foundation. Imogen, his 16 year old daughter is on the foundation’s Junior Advisory Board. I believe that Andy, if not already on their payroll, will end up as their Executive Director.

  154. #154 Igor
    November 14, 2011

    @151: You just dson’t get it, when pressed to provide actual answers to the actual questions, as is sometimes expected by the less brilliant, Blackheart explained that his level of intellect allows him to give multidimensional answers which address the asked questions and much more. Our inability to comprehend his multidimensional answers is the direct result of Blackheart’s superior intellect and knowledge.

    It is difficult to frame one’s answers at the correct intellectual ability. Obviously I had thought you a person who, can throw around some Latin and has a mind for paranormal trivia, was one who might rise to the challenge of intellectual discourse.

    If you can’t even list the 3 locations where the ghost of Edward Jenner commits seppuku or what “Quidquid latine dictum sit, altum videtur” means, then your are ill equipped to understand why Wakefield is a man of honor and integrity. Sheesh.

  155. #155 Krebiozen
    November 14, 2011

    Blackheart,

    It is difficult to frame one’s answers at the correct intellectual ability.

    I had noticed you have been struggling in that regard. A clear statement of your position supported by evidence with a citation seems to be quite beyond you.

  156. #156 Chris
    November 14, 2011

    Is there a Latin phrase for argument from incoherent rambling?

  157. #157 Denice Walter
    November 14, 2011

    Well…Thanks so very much for your support, my friends- just another one of the perks of being a member of the Trans-Atlantic Consortium ( a/k/a “Our Thing”)- it’s not just vast wealth and luxury goods coming our way – we’re *family*! Plus great parties! I can’t argue with that!

  158. #158 Allison
    November 14, 2011

    Intriguing post I thought it was great, so keep at it.

  159. #159 Mrs. Woo
    November 14, 2011

    I have noticed something (realize that, though I have lurked and enjoyed for a long time there are things I only develop the courage to share as time goes by). Most alternative people, be they supporters of it or purveyors, tend to move quickly to insults, yelling and name-calling, or, if nothing else, the conspiracy-theory ideas when confronted with other possibilities. Mr. Woo has the nasty habit of calling me “stupid” during our debates (okay, that is misleading, he says, “What are you? Stupid?” when I try to understand what basis he has to support his beloved alternative medicine).

    Is this because their acceptance of woo comes from more of an emotional appeal than intellectual and they have no real defense?

    Since many of you have been defending medicine much longer than I have, I was just curious if my observation is generally correct.

  160. #160 Anton P. Nym
    November 14, 2011

    Is there a Latin phrase for argument from incoherent rambling?

    Not that I know of, but I do like the automotive metaphor of “doing verbal donuts”; an argument making lots of noise and smoke but going nowhere.

    — Steve

  161. #161 Denice Walter
    November 14, 2011

    @ Mrs Woo:

    Sure. Have you ever read woo-ful websites: it’s rather common amongst the “thought” leaders of these groups. The retreat into emotional “reasoning” fits nicely with the executive dys-function idea and other issues.

    -btw- to comment on your question on the other thread: see Psychiatric Times Vol.28 # 3 ( March 2011) ” Autism and Schizophrenia”. More stuff coming out.

  162. #162 hoary puccoon
    November 14, 2011

    Igor @153–

    Whoa– I stand corrected! Since I haven’t studied Latin since it was taught by people in togas, I obviously missed the masterlyness of Blackheart’s presentation. (Or, presentationism, as a former president might say.)

  163. #163 TBruce
    November 14, 2011

    s there a Latin phrase for argument from incoherent rambling?

    Argumentum a pervagatior disiunctus.

    This is a literal translation using an internet-based translater. I don’t know if it’s correct (I could have been a Judge, but I never had the Latin), but it does sound erudite and all that. If any Latin scholars are here, please feel free to comment.

    I’m going to save it, no doubt it will come in handy.

  164. #164 lilady
    November 14, 2011

    @ Chris:

    Is there a Latin phrase for argument from incoherent rambling?

    argument from incoherent rambling=argumentum a pervagatoir disiunctus (Source “Google Translate”)

    P.S. Willowbrook Wars, eh. Give me your take on the book. I found it incredibly accurate and interesting…but then I know many of the key “players”.

  165. #165 lilady
    November 14, 2011

    TBruce gets the internet award…edged me out by 3 minutes…drat.

  166. #166 Chris
    November 14, 2011

    lilady, the book was interesting. Though I found myself a little confused at the constant use of acronyms, and then the courtroom scenarios.

  167. #167 dt
    November 14, 2011

    “Is there a Latin phrase for argument from incoherent rambling?”

    Argumentum loquendo cum inconsequenta?

  168. #168 ArtK
    November 14, 2011

    @ blackheart (136 & 137):

    It is difficult to frame one’s answers at the correct intellectual ability.

    A person of supposed superior intellectual ability should have no problem framing their answers to the intellectual ability of their audience. I can communicate clearly with PhDs and with 5yo kids — what’s your problem?

    Your pseudo-intellectual blather is a transparent way of hiding your inability to make a point (or even your lack of a point.)

  169. #169 Prometheus
    November 14, 2011

    ArtK (#167, commenting to “Blackheart”):

    “Your pseudo-intellectual blather is a transparent way of hiding your inability to make a point (or even your lack of a point.)”

    Whenever I see a commenter use the “you’re so dumb that I can’t get down to your level” argument, I begin to strongly suspect that they are in their mid-to-late teens. This is a common “argument” used in the Middle School age group as a way of deflecting questions or criticisms that the teen cannot answer.

    I’ve worked with (and taken classes from) people who were very brilliant but unable to frame their topic in ways that “laypeople” could understand and I’ve never heard them say, “You’re too dumb for me to communicate with.” This “argument” – in my experience – is limited to those who don’t really understand what they’re talking about and wish to keep that fact a secret.

    “Blackheart” isn’t the first to try this tactic (and probably not the last, either). And while he may not be a spotty fourteen-year-old boy reveling in his ability to hurl insults at his intellectual betters, he certainly acts like one.

    From the tone (and lack of substance) of his “arguments”, I assume that “Blackheart” is not interested in debating his point (if one exists) but merely wants to stir up activity for his own amusement. I get enough of this at home (from my own teens), so I ignore his comments unless they show up indirectly in the comment of someone else.

    “Blackheart”, if you have a point, you should be able to make it clearly. If not, you either don’t understand what you are arguing or you don’t want to make a point. It’s just that simple.

    Prometheus

  170. #170 dt
    November 14, 2011

    New evidence of yet more problems with Wakefield’s data.

    Olmsted’s “pre-emptive strike” against Brian Deer seems to suffer from the same problem that David Lewis’ letter in support of Wakefield has – it merely makes things look a whole lot worse for St Andy and his Lancet study.

    You see, Olmsted rants about how Deer was possibly misled by an error in Child 11′s hospital discharge records, where it said that the autistic symptoms started at 13 months (2 months before the MMR, which was what Deer had reported).

    In an interview with Olmsted, the father exonerates Deer for that honest mistake. And it seems the father is crystal clear on one point – the boy’s relevant behavioural symptoms began at 18 months, 3 months after MMR. But very unfortunately for Wakefield, this fact lands him right up fraud creek again without even an arm to scoop the water with, never mind a paddle.

    You see, in the Lancet paper, Wakefield is very specific. Child 11′s behavioral symptoms of autism are (wrongly) stated to have started only 1 week after the MMR, a truncated timeline that seems from the paper to be essential in order for Wakefield to be able to implicate reactions from the vaccine with the onset of autism symptoms.

    I wonder how Wakefield will explain this inconvenient revelation of yet another “error” in his paper? Perhaps wax in his ear when he took the child’s history? Dust in his eye when he read the medical reports? Hand written notes which he has subsequently “lost”?

    As someone else said, with friends like Lewis and Olmsted, who need enemies?

  171. #171 brian
    November 14, 2011

    @dt

    Brian Deer wrote: “What the paper reported as a ‘behavioural symptom’ was noted in the records as a “chest infection.”

    While it’s difficult to imagine that a “chest infection” could be a behavioral sign, surely CRYING might be, and child 11, like the others in the study, probably cried immediately following the injection. Thus Wakefield could more logically have claimed a temporal association of vaccination with the onset of behavioral signs based on the first appearance of such “behavioural signs” within seconds of vaccination!

  172. #172 Jud
    November 14, 2011

    The (intellectual?) property resides with the institution formerly Royal Free Hospital now University College London Partners. Of course intellectual property also resides with one’s employers a source of some consternation for skeptiks trying to envisage that Andy Wakefield were going to make money out of ‘transfer factors’.

    As an attorney who has taken intellectual property disputes to court, I’m just in awe of blackheart’s abilities to diagnose the economic and legal relationships among the parties sans any of the contractual documents governing same.

    You do see the difference between intellectual and actual property ?

    Once again I’m left dumbfounded by blackheart’s multidimensional intelligence. He’s able to use a term (“actual property”) with which over 35 years of legal education and experience had not previously acquainted me. But I am sure that blackheart will find me a legal dictionary considered authoritative in the trade, cite the dictionary, and provide me with the definition of the term “actual property” used therein. Right, blackheart?

  173. #173 ken
    November 14, 2011

    Anybody- I’m new at this- Is this Wakefield’s paper they are disputing?
    Is this his only paper in dispute?

    http://www.nature.com/news/2011/111109/full/479157a.html

    http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(97)11096-0/fulltext

  174. #174 Beamup
    November 14, 2011

    That’s the one.

  175. #175 lilady
    November 14, 2011

    @ Jud: Could Blackheart mean “real” or “tangible” property?

    (IANALBMTO)

  176. #176 Prometheus
    November 14, 2011

    Ken,

    The paper you linked to (Lancet 1998) is the paper under discussion, but at least one other Wakefield paper has been retracted (Am. J. Gastroenterol. 2000 – retracted 2010) and at least one Wakefield paper was withdrawn prior to publication (Neurotoxicology 2009).

    Although I don’t know of any formal investigations underway at present, I think that all of Dr. Wakefield’s paper pertaining to measles or autism are suspect, given the level of “irregularity” involved in the retracted papers.

    Jud,

    I am also not a lawyer, but I would be interested in knowing the types of property in the legal field. Also, doesn’t “intellectual property” pertain more to things that can be copyrighted or patented? I’m not sure what the legal status of lab data (like my lab notebooks) might be – can you enlighten me?

    Prometheus

  177. #177 ken
    November 14, 2011

    @Beamup
    @Prometheus

    Thanks

  178. #178 Igor
    November 14, 2011

    As an attorney who has taken intellectual property disputes to court, I’m just in awe of blackheart’s abilities to diagnose the economic and legal relationships among the parties sans any of the contractual documents governing same.

    As a U.S. barred commercial litigator with working knowledge of IP law, I am ill equipped to comment on British law (despite U.S. deriving it’s legal system from British common law and adversarial nature). Only one conclusion is obvious from BH’s show of mastery of Brit law – contracts do not exist there.


    Could Blackheart mean “real” or “tangible” property?

    Fungible property or goods are my favorite.

  179. #179 Igor
    November 14, 2011

    One more time with block quotes intact.

    As an attorney who has taken intellectual property disputes to court, I’m just in awe of blackheart’s abilities to diagnose the economic and legal relationships among the parties sans any of the contractual documents governing same.

    As a U.S. barred commercial litigator with working knowledge of IP law, I am ill equipped to comment on British law (despite U.S. deriving it’s legal system from British common law and adversarial nature). Only one conclusion is obvious from BH’s show of mastery of Brit law – contracts do not exist there.

    Could Blackheart mean “real” or “tangible” property?

    Fungible property or goods are my favorite.

  180. #180 Sauceress
    November 14, 2011

    “Is there a Latin phrase for argument from incoherent rambling?”

    For Blackheart’s particular brand, I think it’s
    Interllectualis masturbatio.

  181. #181 dt
    November 14, 2011

    Even if Wakefield arranged for IP rights to be signed to the Royal Free, the regulations for the UK state that:

    “Income generated by the successful IP exploitation is normally shared between the originating Trust, the inventor and the commercial partner.

    http://www.nic.nhs.uk/Pages/NHSIPGuidance.aspx

    The commercial company created by Wakefield to exploit the use of Transfer Factor in sick children was “Immunospecifics Biotechnologies Ltd”, and he stood to gain income as its research director, so even had IP rights been asigned to the Royal Free he would have stood to gain financially.

  182. #182 Jud
    November 14, 2011

    Could Blackheart mean “real” or “tangible” property?

    Since blackheart very obviously had no idea what he was talking about, what he meant could have been an absurdity, immaterial…virtually anything but correct or worthwhile worrying about.

    “Real” property is land. “Tangible” property is something physical. Intellectual property is usually considered intangible, but the division between tangible and intellectual property isn’t necessarily absolute. Consider a piece of jewelry, which has value as a physical object and as the embodiment of intellectual property, i.e., the design.

    Prometheus, the answer re your lab notes, as for many if not most general questions, is “it depends.” That’s not ducking the question, it’s the only correct answer under the circumstances. Your lab notes could be anything from public information, to classified, to part of a trade secret, to the subject of copyright (e.g., some of the medical records pertaining to Henrietta Lacks are now the subjects of copyright insofar as they’ve become part of Rebecca Skloot’s book), to support for a patent application, to evidence against granting a patent, to business confidential but not necessarily having intellectual property status….

  183. #183 lilady
    November 14, 2011

    @ Sauceress: Naughty, naughty…but hilarious.

    @ Jud: Thanks for clarifying about Blackheart’s use of “actual property” (IANALBMTO)…so I knew he was talking about something that he is clueless about.

  184. #184 blackheart
    November 14, 2011

    Krebiozen

    I had noticed you have been struggling in that regard. A clear statement of your position supported by evidence with a citation seems to be quite beyond you.

    Is there a question that needs citation ? Herr Doktors question on the who were the 3 Gastroenterologists is self evident from the Lancet 12 paper.

  185. #185 blackheart
    November 14, 2011

    Lilady

    “Wakefield set up two offshore (Ireland) corporations…Immunospecifics Bioltechnologies Ltd. & Carmel Healthcare Ltd. ***”Carmel” Healthcare Ltd”

    …and you can cite the original Republic of Ireland company records showing all aspects of company ownerships including shareholders and including dates of incorporation.

    My family doctor, a fine fellow has a limited company probably named after his wife as well or the names of his children.

    Part of the Wakefield conspiracy is he ?

    No … didn’t think so.

  186. #186 blackheart
    November 15, 2011

    TBruce

    This is a literal translation using an internet-based translater.

    Which sort of reinforces the point I previously made about the depth of the arguments here.

    As a pathologist and therefore a professional colleague of Professor Dhillon’s perhaps you’d like to lend us your expertise on the matter of the pathology he reported on.

  187. #187 blackheart
    November 15, 2011

    Prometheus

    Whenever I see a commenter use the “you’re so dumb that I can’t get down to your level” argument

    It’s not about me coming down it’s challenging you to raise your level. When debating classical Grecian philosophy I don’t ask who were the three most famous philosophers….it’s kind of taken as a given that to eneter that debate you would have the a solid base of knowledge.

    “You’re too dumb for me to communicate with.”

    It’s not a question of being ‘dumb’ it’s a question of thinking in more complex terms.

    Not everyone understands it and not everyone can practice it. I’ve discussed matters pertaining to this before in terms of fluid and crystallised intelligence.

    It would appear that these boards are full of the latter.

    so I ignore his comments unless they show up indirectly in the comment of someone else.

    That’s a rather strange thing to do.

    I’ve challenged you and shown you some very basic errors in your posts previously. Yet you to continue to make these simple errors … the challenge for you is to debate without such error. Just as it was with the Herr Doktor.

    Blackheart”, if you have a point, you should be able to make it clearly.

    Certainly I’ll reiterate it again … from post #94 and added to it

    “Are you implying that “three of the world’s leading gastroenterologists” did find a “paediatric gastro disease pathology”?

    Certainly I thought that was obvious.

    These being?

    “an unusual gastrointestinal abnormality characterised by ileal-lymphoid-nodular hyperplasia and non-specific enterocolitis that is not classical inflammatory bowel disease.”

    “lymphoid hyperplasia/ microscopic colitis changes were found in over 90% of the autistic children studied. Even if there is no immunodeficiency, the lymphoid hyperplasia in many cases is remarkable, with germinal centres showing higher numbers of proliferating (Ki67 positive) cells than we have detected in any immunodeficient controls with lymphoid hyperplasia. We are very familiar with the detection of lymphoid hyperplasia in children with minor immunodeficiency, as are Lindley and Milla, and have published several reports on this topic. We were thus ideally placed to detect the exaggerated lesion found in many of these children. The colitis itself is variable, but may feature crypt abscesses, increased macrophage infiltration and unregulated class II major histocompatibility complex expression.”

    The Lancet – John Walker-Smith, Simon Murch , Mike Thomson. 1998

    http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2805%2970323-8/fulltext

    Further reinforced …

    “I belive that the published data in peer reviewed journals show two things. First, a highly selected group of children with developmental disorder (many with regressive autism) exists, who have an unusual gastrointestinal abnormality characterised by ileal-lymphoid-nodular hyperplasia and non-specific enterocolitis that is not classical inflammatory bowel disease.”

    “The immunopathology of this disorder has been studied by Furlano and colleagues4, who have established clear differences from chronic inflammatory bowel disease.”

    “Furlano and colleagues’ work on the inflammatory changes and the intestine in autism was reviewed in the Medical Research Council’s 2001 report. Some criticisms were made but the work was certainly not refuted.”

    John Walker-Smith 2001

    http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2802%2907783-8/fulltext

    Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, nonspecific colitis, and pervasive developmental disorder in children. Lancet 1998; 351: 637-641. Summary | Full Text | PDF(942KB) | CrossRef | PubMed

    2 Walker-Smith JA. Autism, inflammatory bowel disease, and MMR vaccine. Lancet 1998; 351: 1356-1357. Full Text | PDF(40KB) | CrossRef | PubMed

    3 Wakefield AJ, Anthony A, Murch SH, et al. Enterocolitis in children with developmental disorders. Am J Gastroenterol 2000; 95: 2285-2295. CrossRef | PubMed

    4 Furlano RI, Anthony A, Day R, et al. Colonic CD8 and gamma delta T-cell infiltration with epithelial damage in children with autism. J Pediatr 2001; 138: 366-372. CrossRef | PubMed

    5 Uhlmann V, Martin CM, Silva I, et al. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. http://mp.bmjjournals.com/cgi/content/full/54/6/DC1. (accessed on Feb 19, 2002).

  188. #188 blackheart
    November 15, 2011

    Jud

    As an attorney who has taken intellectual property disputes to court, I’m just in awe of blackheart’s abilities to diagnose the economic and legal relationships among the parties sans any of the contractual documents governing same.

    Thank you for your kind words I to am in ‘awe’ of my abilities. But to this point a simple reading of Messr Deer’s articles suffices.

    Once again I’m left dumbfounded by blackheart’s multidimensional intelligence.

    Thank you once again for your kind accolades.

    Right, blackheart?

    Only an attorney would try to attempt that semantic tango . My response …meh. (It’s in the Urban Dictionary)

    If you have a more challenging point to make you always have the opportunity I am as always magnanimous.(Oxford Dictionary)

  189. #189 blackheart
    November 15, 2011

    dt

    “Income generated by the successful IP exploitation is normally shared between the originating Trust, the inventor and the commercial partner.

    Correct … and the position for Crown employees.

    “Immunospecifics Biotechnologies Ltd”, and he stood to gain income as its research director, so even had IP rights been asigned to the Royal Free he would have stood to gain financially.

    …and how is this, other than normal business practice in regards to financial exploitation of research by Crown institutions, as encouraged by Her Majesty’s Government ?

    Here’s an example …

    Pentraxin Therapeutics Ltd

    “Pentraxin Therapeutics Ltd, a UCL spinout company founded and directed by Professor Pepys and Mr Cengiz Tarhan, Managing Director of UCL Business PLC. The Pentraxin Therapeutics Ltd portfolio comprises treatments for amyloidosis and for cardiovascular and inflammatory diseases. The most advanced project is the development of a unique small molecule and humanised monoclonal antibody combination for treatment of systemic amyloidosis. The I.P. was licensed to GlaxoSmithKline in February 2009 and a fully collaborative clinical development programme is in progress aiming for first patient studies in 2012.”

    http://www.ucl.ac.uk/medicine/amyloidosis

    Normal business practice … not some conspiracy theory.

  190. #190 blackheart
    November 15, 2011

    IANACOL

    But I think that just went skeptiks 0 – Blackheart 1

    All men can see these tactics whereby I conquer, but what none can see is the strategy out of which victory is evolved.

    Sun Tzu

  191. #191 puppygod
    November 15, 2011

    All men can see these tactics whereby I conquer, but what none can see is the strategy out of which victory is evolved.
    Sun Tzu

    Have you read further verse?

    “He who can modify his tactics in relation to his opponent and thereby succeed in winning, may be called a heaven-born captain.”

    You are way too repetitive. Also, ability to quote strategist don’t make you one.

  192. #192 ArtK
    November 15, 2011

    I think we have an incipient case of Dunning-Kruger in Blackheart. He seems very impressed with his own intelligence — far more than the rest of us are impressed with it.

    “Are you implying that “three of the world’s leading gastroenterologists” did find a “paediatric gastro disease pathology”?

    Certainly I thought that was obvious.

    These being?

    “an unusual gastrointestinal abnormality characterised by ileal-lymphoid-nodular hyperplasia and non-specific enterocolitis that is not classical inflammatory bowel disease.” …

    Nice job missing the point of Prometheus’ comment. Prometheus wasn’t denying that three people published conclusions that they found abnormalities. It was your contention that these were “three of the worlds leading gastroenterologists.” It’s been pointed out that they are nowhere near that level. It’s also been pointed out that a number of pathologists disagree strongly that there were any abnormalities, based on the scoring sheets of these so-called leading gastroenterologists.

    The conclusions of these “experts” are suspect for a number of reasons. As noted, other, real experts, disagree — pointing out that mistaken conclusions of this kind are easy to make in this kind of analysis. Occam’s Razor and all, there are simpler explanations for their observations. Second, they’re suspect because people at the time disagreed and then changed their minds without any explanation. Third, they’re suspect because nobody has been able to reproduce their results.

  193. #193 Igor
    November 15, 2011

    He is a brilliant strategist. lying in wait for hours until the time required in search for self servient quotations of renowned historical figures BH aspires to be, let all that brilliance and score keeping abilities go to waste. BH is the poster child for the Dunning-Krueger effect.

    When debating classical Grecian philosophy I don’t ask who were the three most famous philosophers….it’s kind of taken as a given that to eneter that debate you would have the a solid base of knowledge.

    There many other seasons I refrain from asking such pointless nonsense. That the answer is a given to you is fascinating because I rarely contemplate such subjective and useless top 3 comparisons.

    Surely someone who boast of such multidimensional intelligence needs access to more than 2 online dictionaries. You are at the cutting edge of brilliants, able to Wikipedia, Google search and post at the same time. A veritable regurgitation of information provided its dimensions do not exceed those of your intellect.

    It’s not a question of being ‘dumb’ it’s a question of thinking in more complex terms.
    Not everyone understands it and not everyone can practice it. I’ve discussed matters pertaining to this before in terms of fluid and crystallised intelligence.

    Perhaps you can direct some of us to a qualified interpreter? What’s the point of such great ability if the rest can’t comprehend the multidimensional, multi-audience and fluid intelligence able to go off on many irrelevant tangents at once. Have you considered that focusing on one thing at a time might be less incredible then talking trying to talk to everyone about everything at once?

    I suspect BH is about to reach the God/hot burrito critical point. Can he utilize so many layers at maximum fluidity that no one in the world will ever understand him again? Or will his superior mind find new ways to communicate with mere mortals, perhaps via a a booming voice in the sky? Or glossolalia?

  194. #194 Chris
    November 15, 2011

    blackheart = Interllectualis masturbatio

    (thanks Sauceress!)

  195. #195 Prometheus
    November 15, 2011

    Why is it that when I read “Blackheart’s” last few comments I immediately thought of Charlie Sheen saying “Winner!”?

    Prometheus

  196. #196 Calli Arcale
    November 15, 2011

    “But I think that just went skeptiks 0 – Blackheart 1″

    Danth’s Law comes to mind.

  197. #197 lilady
    November 15, 2011

    It is difficult to figure out what blackheart’s agenda is…aside from being an uneducated physician/lawyer wannabe and apologist for Wakefield/Walker-Smith.

    Is he so morally bankrupt that he is unable to understand the non-existent medical ethics exhibited by Wakefield. Does he not comprehend that Wakefield was hired by lawyers BEFORE he began embarked on his “research” on the children who were referred to him by these same lawyers?

    He now links us to an article about amyloidosis research…without really knowing about the many auto-immune diseases and genetic disorders that are manifested by amyloid plaques within the human body.

    What about the two offshore corporations that were set up by Wakefield to provide laboratory test kits to test for his yet unproven theory of autistic enterocolitis, and for the marketing of a single antigen measles vaccine that he was developing.

    Wakefield was judged by his peers at the GMC and found to be guilty of egregious medical malpractice upon these children that were used as guinea pigs.

    Anyone who continues to defend Wakefield, in the face of the thorough investigation of his unethical dealings with lawyers and his unconscionable treatment of the subjects of his experimentation, has to be amoral, a fool or an amoral fool.

    Now just go away blackheart…I feel dirty just reading your drivel.

  198. #198 Jud
    November 15, 2011

    blackheart writes:

    My response …meh.

    Translation of what the “multidimensional intelligence” said: “I got nothin’.”

    Sheesh, fella, what an utter non-effort. You’re in danger of failing to medal in the Trollympics.

  199. #199 TBruce
    November 15, 2011

    As a pathologist and therefore a professional colleague of Professor Dhillon’s perhaps you’d like to lend us your expertise on the matter of the pathology he reported on.

    I am not impressed. Most of the “abnormalities” noted on the worksheets are subjective observations of mild variations in histology.

    A “slight increase in lamina propria mononuclear cells” is noted in the cecum in 9 of the subjects. Normal cecum has more mononuclear cells than the rest of the colon. I don’t see how a slight increase could be diagnosed.

    Lymphoid aggregates and follicles in a child are not abnormal.

    Intra-epithelial lymphocytes are mentioned but not counted. This observation is worthless. Up to 5 lymphocytes per 100 epithelial cells is normal.

    Three subjects have “occasional lamina propria polymorphs”.
    This could be secondary to bowel prep. If you’ve ever had a bowel prep, you’ll know why.

    Child nine seems to have significant changes, with a high score for chronic inflammation and mild but widespread crypt distortion. I would wonder if he has some form of chronic inflammatory bowel disease. The others I would consider “within normal limits”.

    This is a feeble basis for postulating a new pathologic entity. In addition to the lack of rigor (no quantitation, questionable findings of subtle variations), there seems to be no attempt at “blind” evaluation, and Wakefield himself seems to be sitting in during the evaluation process. The paper should have been binned for this reason alone.

  200. #200 brian
    November 15, 2011

    There’s so much that’s strange about Wakefield’s retracted Lance paper, but I just have to ask:

    Wakefield wrote: “In eight children, the onset of behavioural problems had been linked, either by the parents or by the child’s physician, with measles, mumps, and rubella vaccination.” How could Wakefield have determined that “In [the only eight children included in his anaylsis] the average interval from exposure to first behavioural symptoms was 6.3 days (range 1–14).

    First off, whether you use “1 week” or substitute “7 days,” that’s still only one significant figure. How did Wakefield report two significant figures (6.3 days) as a result? (Really, why did he not go all-in and report an apparently more precise ’6.625 days’?)

    Second, could someone explain how the results from those children average “6.3 days”? It seems that Wakefield either did not report the data that he used in his calculations or he can’t do simple division.

    Third, as Brian Deer pointed out, Wakefield excluded from his calculation three children whose parents reported their belief that MMR was “linked” with the development of behavioral signs. “Parents [of child 5] have no doubt about the relationship with MMR,” but Wakefield excluded that child. “Mother [of child 9] linked his mental regression at age 18-20 months to MMR,” but Wakefield excluded that child from the analysis. Wakefield himself wrote of child 12, “Autistic spectrum disorder and bowel disorder after MMR,” but excluded the child from the analysis. Moreover, somehow 4 weeks between vaccination and the onset of behavioral signs became 1 day for child 4 between drafts of the paper, as Deer reported.

    Etc.

    Using all of the 11 children who were believed by their parents to have developed behavioral signs due to MMR (rather than using only the 8 children that Wakefield chose to include), the average time to onset of symptoms is about 4 weeks. Of course, that calculation uses the figure reported in the Lancet (2 weeks) rather than the information given to Deer by the mother of child 2: “From memory, about six months, I think.”

    Deer reported: “’Dr Wakefield feels that if we can show a clear time link between the vaccination and onset of symptoms,’ Barr told the legal board, “‘we should be able to dispose of the suggestion that it’s simply a chance encounter.’” I suppose that a month or more wouldn’t have sufficed for Wakefield’s purpose–so he fixed it.

    Even if Wakefield was, as he wrote, simply “in attendance” during the pathology review of the slides that had been read as normal and was not the AJW who “evaluated” (in the August 1997 draft of the paper) or “assessed” (in the Lancet paper) “all tissues,” and he accurately reported and made no attempt to influence the unblinded review by his colleague, Wakefield still has quite a bit to answer for.

  201. #201 blackheart
    November 15, 2011

    Jud

    That must have been quite the embarrassing moment …surprise me and lift the intellectual quality of your debate.

  202. #202 blackheart
    November 16, 2011

    TBruce

    I am not impressed.

    There’s a surprise.

    What is interesting is that any of the BMJ’s pathologist with any appreciation of scientific rigour and objectivity would never make comment on incomplete data sheets.

    They would submit a written document / evaluation signed and dated.

    In this document they would thoroughly review each and every case outlining the strengths and weaknesses of their findings and any problematic factors such as not verifying against actual pathology specimens.

    Nor would they make comment if they knew that there was additional material available through the GMC enquiry directly related to these patients. ie another set of pathology reports.

    Further as a research team member the original pathologist a Professor at a teaching hospital, no less met weekly with other team members particularly of note the three renowned paediatric gastroenterologists.

    As this witness was cross examined under oath at the GMC it seems implausible that there was any “fraud” involved.

    —————————————————

    “All intestinal biopsy tissues went through three rounds of microscopic review: the first from the duty non-specialist histopathologist, the second by Professor Walker-Smith and his team, and the third – a blinded review – by Dr Amar Dhillon, the senior pathologist with expertise in intestinal diseases.

    Statement of Dr. A.P. Dhillon to the GMC

  203. #203 blackheart
    November 16, 2011

    Lilady

    “Wakefield set up two offshore (Ireland) corporations…Immunospecifics Bioltechnologies Ltd. & Carmel Healthcare Ltd. ***”Carmel” Healthcare Ltd”

    …and you can cite the original Republic of Ireland company records showing all aspects of company ownerships including shareholders and including dates of incorporation ?

    Away you go … or is this another evidence free zone.

  204. #204 blackheart
    November 16, 2011

    Before publishing Lewis’s letter, the BMJ asked Ingvar Bjarnason, a gastroenterologist at King’s College Hospital, London, to review the materials.

    But he says that the forms don’t clearly support charges that Wakefield deliberately misinterpreted the records. “The data are subjective. It’s different to say it’s deliberate falsification,” he says.’

    Well it certainly would be seeing as we now know who undertook all three review processes and Andy Wakefield’s name isn’t in it.

    ———————————————–

    When is a fraud not a fraud when it’s a difference of opinion.

    Such conspiracies … baaaa !

    ps Of course I’m still backing the guys that actually looked at and studied those pathology slides.

    But hey … always magnanimous.

  205. #205 TBruce
    November 16, 2011

    Blackheart:

    Whatever.

    You asked me to comment on the worksheets and I did. Nothing you say changes my assessment. I would be open to changing my mind if:

    - other pathologists not associated with the study had differing views. IIRC, other pathologists have commented, with conclusions similar to mine.

    - I could have a look at the slides from these cases. Oh, yeah, that’s not possible. Funny, that…

  206. #206 Beamup
    November 16, 2011

    “So what” seems an appropriate response. Let’s suppose, for the sake of argument, that Wakefield had honestly put into the paper what he believed Dhillon had found.

    The thing is still chock-full of lies. Concealing the facts that Wakefield was being paid by the lawyers, and the patients were referred by the lawyers and were plaintiffs, would in itself be enough to completely destroy all credibility. Changing the course and timing of symptoms would still qualify as outright fraud.

    So even in the best case, the conclusion is that Wakefield committed both deliberate fraud AND gross incompetence.

  207. #207 Brian Deer
    November 16, 2011

    @TBruce

    There’s more that you would appreciate. You will hear a lot from Wakefield’s people about a “blinded review”. Indeed, his Lancet paper refers to 5 age-matched and site matched controls, and acknowledges where he says he got them.

    In fact, an earlier version of the paper refers to 10 such controls (so five went AWOL).

    And these ten were supplied by a pathologist at another hospital who says she supplied 10 “normal” biopsies, which were neither age- nor site-matched. (You’ll know all that left-side – right-side stuff. I can even do Paneth cells these days, god help me).

    So what you get for controls are not samples from non-autistic children with constipation. What you get are random normal controls which are not matched for anything (and how would you site- or age match- them against 62 ileocolonic biopsies from 11 patients anyway) and which – having been pre-selected for zero inflammatory changes – create the greatest imaginable selection bias.

    And that’s even before the number is whittled down from 10 to 5.

    So, what are we to make of Wakefield’s claim in the paper that: “None of the changes described above were seen in any of the normal biopsy specimens”?

    We published these sheets because Wakefield and his new pal claimed they vindicated him.

    I love these people.

  208. #208 brian
    November 16, 2011

    Blackheart wrote:

    [We] now know who undertook all three review processes and Andy Wakefield’s name isn’t in it.

    Blackheart, are you accusing Wakefield of lying?

    Andrew J. Wakefield wrote in the August 1997 draft of his paper:

    All tissues were evaluated by a further 3 clinical and experimental pathologists (APD, AA, AJW).

    Andrew J. Wakefield wrote in the Lancet paper:

    All tissues were assessed by three other clinical and experimental pathologists (APD, AA, AJW).

    Of course, Wakefield wrote in Callous Disregard that he was merely “in attendance” to suggest that he certainly did not “assess” or “evaluate” the tissues, so whatever was found, it wasn’t his fault; perhaps Wakefield never said a word but just made tea and fetched extra grading sheets.

    Since those statements in the draft, the final paper, and Callous Disregard cannot all be true, which of Wakefield’s statements do you think must be false? Did he or did he not “evaluate” or “assess” the tissues, as he wrote?

    Nonetheless, perhaps you are correct when you said of the review process that “Wakefield’s name isn’t in it”. Just his initials.

  209. #209 Prometheus
    November 16, 2011

    To echo “Beamup” (#206), as soon as it was revealed that the subjects of his 1998 Lancet paper were not just 12 random children who had been “…consecutively referred to the department of paediatric gastroenterology with a history of a pervasive developmental disorder with loss of acquired skills and intestinal symptoms…” but were, in fact, recruited by solicitors and on the Internet, the wheels came off the study.

    For me, everything past that point was simply “piling on”. It was apparent almost from the start that the study was not valid (because the subjects were “hand-picked” to present exactly what Wakefield’s article proposed to find) and the rest of the evidence merely elevated the failing from gross incompetence to probable fraud.

    At any rate, the legitimacy of the “findings” in Wakefield’s has been nil for years and finding that the pathology reports were also likely tampered with is just another rock landing atop an avalanche.

    What “Blackheart” appears to be arguing is that since “three pathologists” connected to this now-retracted paper (unindicted co-conspirators?) read the now non-existent pathology slides as showing “ileo-nodular hyperplasia” etc., we should ignore the only remaining evidence – the pathology scoring sheets – which seem to indicate that they saw nothing of the sort.

    Given all that has gone before with this study and these researchers, Blackheart’s efforts seem akin to insisting that the Titanic had sufficient watertight compartments when she slipped beneath the waves of the North Atlantic.

    In both cases, the suppositions are both unlikely and irrelevant. Regardless of the “adequacy” of her watertight compartments, the Titanic sank and regardless of what the “three pathologists” (Tres Caballeros?) in the 1998 Lancet study saw or thought they saw, nobody else – except people connected to the Wakefield research group – has been able to replicate their findings.

    It is a pity that the original slides and blocks have been “lost”, but the worksheets seem to indicate that what the “three patholgists” saw as “enterocolitis”, the rest of the pathology community sees as “not significant”, which might explain the failure to replicate the Wakefield 1998 findings.

    At this point, the burden is on the Wakefield researchers to show that their 1998 findings were legitimate, since they haven’t been replicated. Perhaps the “three pathologists” would consent to a test – looking at colon and ileum biopsies from 12 consecutive (truly consecutive) paediatric gastroenterology referrals with “regressive autism” and 12 consecutive referrals without autism (of any kind) to see if they can identify which have “autistic enterocolitis” and which do not.

    I think that would be very illuminating.

    Prometheus

  210. #210 Denice Walter
    November 16, 2011

    AJW may have actually learned from Sir Cyril Burt** whose mistakes included having all his co-efficients of correlation precisely equal to the *third* decimal place and inventing collaborators or subjects.

    However, at least Burt had the good sense to burn his notes and records.

    ** this is most emphatically *not* a “how to” guide.

  211. #211 blackheart
    November 17, 2011

    “You asked me to comment on the worksheets and I did.”

    I didn’t ask you to simply regurgitate … I was expecting a little more complexity and critical application.

    For instance did you take into account the age and diagnostic history of each child ?

    Did you compare it in your professional experience to other pathology that would be relevant. You don’t need control slides for that ?

    What was the diagnosis of each child then if you don’t think there is a case for microscopic colitis seen in conjunction with lymphoid hyperplasia ?

    “- other pathologists not associated with the study had differing views. IIRC, other pathologists have commented, with conclusions similar to mine”

    I was expecting you to show me where the fraud was.

    All I can see in those articles is one or two sentence comments.

    Where’s the detailed signed and dated review ?

    “- I could have a look at the slides from these cases. Oh, yeah, that’s not possible. Funny, that…”

    Where’s the Roswell alien again ?

    The pathology slides are not required. The evidence of disease pathology was confirmed through further examination of some 50 or more children

    Did you forget the elephant in the house ?

    “this mucosal abnormality has been apparent in 47/50 children within the autistic spectrum, whether or not there is any perceived link with immunisation. Thus the lymphoid hyperplasia/ microscopic colitis changes were found in over 90% of the autistic children studied. Even if there is no immunodeficiency, the lymphoid hyperplasia in many cases is remarkable, with germinal centres showing higher numbers of proliferating (Ki67 positive) cells than we have detected in any immunodeficient controls with lymphoid hyperplasia. We are very familiar with the detection of lymphoid hyperplasia in children with minor immunodeficiency, as are Lindley and Milla, and have published several reports on this topic. We were thus ideally placed to detect the exaggerated lesion found in many of these children. The colitis itself is variable, but may feature crypt abscesses, increased macrophage infiltration and unregulated class II major histocompatibility complex expression.

  212. #212 blackheart
    November 17, 2011

    Prometheus

    What “Blackheart” appears to be arguing…

    Wilfully ignorant or ignorantly wilful hard to tell which one Prometheus. Simply unable to distinguish between ‘pathologists’ and ‘gastroenterologists’

    Two layers of evidence converge to show aberrant bowel pathology that shows microscopic colitis and lymphoid hyperplasia.

    Changes were found in over 90% of the autistic children studied. 47 / 50 children

    At this point, the burden is on the Wakefield researchers to show that their 1998 findings were legitimate, since they haven’t been replicated.

    Well indeed they were … here it is again

    Changes were found in over 90% of the autistic children studied. 47/50 children

    That’s a lot of pathology you are going to have to dismiss as ‘mysteriously’ disappeared.

    I think that would be very illuminating.

    I’ll be fascinated how you dismiss 47 pathology reports, slides and all..

    Here’s some help …

    The Great Big Book of Magic Tricks: Amazing Tricks to Impress Your Friends

  213. #213 Brian Deer
    November 17, 2011

    Dr Dhillon has now made a statement. He denies the Wakefield – Lewis claim that he reported non-specific colitis, and passes the buck back to the hospital pathology service and the clinicians (who records show judged the biopsies to have been largely normal at weekly clinico-pathological meetings)

    http://www.bmj.com/comment/rapid-responses

    He also says that some of the forms which Wakefield attributes to him were not, in fact, written by him. So, now we wonder, whose handwriting is it?

    Is it “AJW”, who the Lancet said “assessed” the biospies with Dhillon?

    Or was it “AA” – Andrew Anthony – who was an unaccredited trainee at the time, and was still a trainee eight years later?

    Were the rogue sheets done at the time, or were they added later by someone who didn’t expect that the BMJ would publish them?

    Dhillon also notes that there were additions to the documents. We know that they were added by someone called “Andy” two months ago. I can’t imagine who that was.

    I love these people.

  214. #214 W. Kevin Vicklund
    November 17, 2011

    The forms that Dhillon attributes to someone else are for Children 7,8,10,&12. The first form for each of those 4 children has AA written in the top right corner, in what appears to be the same handwriting as on the rest of the form. APD appears on one of the forms Dhillon does claim as his own. Therefore, it is reasonable to conclude that Andrew Anthony was the person who filled out the other forms. Which as I understand it was already known that he did a review of the slides.

    Note that the only thing Dhillon claims was added was the Child ID. This is perfectly normal as part of the unblinding process, and in fact necessary for us to be able to interpret the results in any meaningful fashion. I have to call out Brian Deer for insinuating something more sinister.

    I will note that on several of AA’s forms, the following note is present at the top of the page:

    *nice control*

    Now that is something worth pondering.

  215. #215 Prometheus
    November 17, 2011

    I read Dr. Dhillon’s response and I found it odd that he repeatedly made mention of the fact that he had no knowledge of the clinical context of the slides he was examining. This, of course, is expected in a blinded study, so his use of this excuse is odd, at the least.

    He also claims that, in 1998 when the paper was being written, that there weren’t any guidelines for grading paediatric gastrointestinal biopsy slides (which I have to assume is true) and then – not a paragraph away – berates other pathologists for using adult criteria for assessing his worksheet notes. It seems odd to accuse others of using the wrong guidelines when he – by his own admission – used none at all.

    Although these questions are highly relevant to Dr. Dhillon’s reputation, they are completely irrelevant to the issue of “autistic enterocolitis”, since it has not been replicated.

    Even if we give Dr. Dhillon benefit of the doubt and assume that he saw real pathology, it would have been random chance (along with a non-random pre-selection of study subjects) that the pathology correlated with autism. We know this because subsequent studies have failed to find a correlation.

    Even if there had been no fraud, no “stacking the deck” by pre-selecting subjects with the “right” story, no questionable reinterpretation of pathology slides, “autistic enterocolitis” would still be a dead hypothesis because the only people who can see it are connected with Andy Wakefield. No independent research group has been able to find “autistic enterocolitis”.

    This isn’t to say that nobody has found that autistic children (or adults) have GI problems or that colitis never occurs alongside autism – those all happen. But the Wakefield group made a very specific claim of a very specific type of pathology seen – so they claimed – only in autistic children who had “regressive autism” after the MMR vaccine. That finding has not been replicated.

    I mention this last bit because I’ve been repeatedly bombarded with lists of studies that are claimed to replicate the Wakefield findings, but the listed studies are always either [a] by colleagues of Dr. Wakefield or Dr. Wakefield himself, [b] about non-specific “GI problems” in autistic people, [c] about “ileonodular hyperplasia” in non-autistic children, [d] letters to the editor or [e] completely irrelevant.

    “Autistic enterocolitis” as a hypothesis has been “mouldering in the grave” for nearly a decade. All that is left is to decide which of the members of the Wakefield group (if any) committed deliberate fraud and which members allowed themselves to be duped – separating the goats from the sheep, as it were.

    Prometheus

  216. #216 Beamup
    November 17, 2011

    I read Dr. Dhillon’s response and I found it odd that he repeatedly made mention of the fact that he had no knowledge of the clinical context of the slides he was examining. This, of course, is expected in a blinded study, so his use of this excuse is odd, at the least.

    It seemed to me that he was saying “I was not diagnosing colitis, I could not have been diagnosing colitis based solely on these slides, to assert that a diagnosis of colitis came from me is false.”

  217. #217 Brian Deer
    November 17, 2011

    @Beamup:

    Which is interesting, because you have two consultant histopathologists. One in the NHS hospital pathology service saying that she didn’t diagnose colitis, but that a research review in the medical school generated this. And the other in the medical school saying that he didn’t diagnose colitis either.

    She said that a “blinded review” (so-called, as if that makes any difference) took precedence because Dhillon looked in “minute detail”.

    He said that the pathology service diagnoses should take precedence because it had clinical information which is vital to this activity.

    It makes me think of Reservoir Dogs when they all stand in a circle and shoot each other.

    But I do love these people.

  218. #218 TBruce
    November 17, 2011

    I didn’t ask you to simply regurgitate … I was expecting a little more complexity and critical application.

    - and I expect you to read my answers for comprehension. I have interpreted the findings. If you don’t like my answers, well, tough.

    For instance did you take into account the age and diagnostic history of each child ?

    No, because it’s not provided on the worksheets. If it’s elsewhere, I’m not about to look for it. I’ll let you “multidimensional thinkers” and “multilayer cakes” do that. I am commenting on the pathologic findings, not attempting to make a diagnosis.

    Did you compare it in your professional experience to other pathology that would be relevant. You don’t need control slides for that ?

    I have examined thousands of colon biopsies in my career. I know what normal colon looks like.

    What was the diagnosis of each child then if you don’t think there is a case for microscopic colitis seen in conjunction with lymphoid hyperplasia ?

    I stated that in all but one of the cases, the colon biopsies (as described on the worksheets) were normal. I’m not in a position to “diagnose” each child.

    Did you forget the elephant in the house ?

    The room. It’s “the elephant in the ROOM”. If you’re going to stoop to using a cliche, at least use it correctly.

    Anyway, are these elephant keepers associated with Wakefield’s study, or are they independent? That does make a difference.

    Also see comment #62 from Dangerous Bacon. I concur.

  219. #219 TBruce
    November 17, 2011

    Futrher to my comment #218:

    John Walker-Smith appears to be the head elephant keeper. This is not an independent opinion and therefore is worthless as far as I’m concerned.

  220. #220 blackheart
    November 17, 2011

    TBruce

    The room. It’s “the elephant in the ROOM”. If you’re going to stoop to using a cliche, at least use it correctly.

    You just missed another multilayered reply …

    apparently this particular elephant is now rampaging through all the allegations made against John Walker-Smith and his professional colleagues.

  221. #221 W. Kevin Vicklund
    November 17, 2011

    apparently this particular elephant is now rampaging through all the allegations made against John Walker-Smith and his professional colleagues.

    You may have a point there. It’s quite possible that Walker-Smith and Wakefield are a veritable Fleischmann and Pons.

  222. #222 TBruce
    November 18, 2011

    blackheart:

    Ooh, a multilayered cliche. How kewl.

    – and you have completely missed everything I have presented, multilayered or not.
    Why should I bother?

  223. #223 blackheart
    November 18, 2011

    TBruce

    My research review of the slides in 1998 has important differences with the routine diagnostic histopathology process:

    -Routine diagnostic histopathology is done with knowledge of individual patient’s clinical details as far as they are available at the time of diagnostic reporting, and so the rendering of a diagnostic histopathological opinion in this situation is usual and appropriate (in direct contrast to the situation that pertains in a blinded research review)

    -Then there is a joint review by clinicians and pathologists to evaluate the significance of the microscopic observations in the light of additional clinical, endoscopic, radiologic, and laboratory data that has been obtained after the “diagnostic” biopsy has been reported

    -It is not unusual for the clinical significance of microscopic observations to be reinterpreted and altered by this process, and it could be that the histological diagnostic interpretation subsequently has to be corrected.

    Thus the purpose of my grading sheet observations in 1998 was not, could not have been, nor was it intended to conclude the final diagnostic assignment of colitis (which has to be made in the light of full clinical/endoscopic/radiologic/ laboratory data; and response to treatment)

    -Therefore on the grading sheets “nonspecific” means: “this microscopical appearance doesn’t remind me of any particular disease entity”, and this is why in none of my grading sheet observations have I stated “colitis”.

    Bowel disease is not diagnosed by gut mucosal histopathology in isolation:

    -I am of the opinion that the histological interpretation should never (or not very often) replace clinical judgement

    - “A final diagnosis can only be made with the full clinical information and a biopsy specimen should be reported as diagnostic only if full supportive clinical information is available.” (Jenkins D et al. Guidelines for the initial biopsy diagnosis of suspected chronic idiopathic inflammatory bowel disease. The British Society of Gastroenterology Initiative. J Clin Pathol 50,93-105;1997).

    -Thus, at the time of submission of the Lancet 1998 publication, with the limited supplementary information available to me (which I had been prevented deliberately from knowing during the study); and in the context of a comprehensive clinicopathological review by trusted clinical colleagues, the designated diagnosis of colitis seemed to me to be plausible.

    ————————————————

    Gonzo’s Big Book of Magic Tricks isn’t working out so well….

  224. #224 LW
    November 18, 2011

    That’s such an awesome response by the aptly-named blackheart; I’ll have to remember it. Any time I say something incoherent, or mess up a commonly used cliche, I’ll say, “You just missed another multilayered reply” and everyone will be all impressed and feel stupid that they missed my pearls of wisdom.

    Or else they’ll just snicker.

    *Snicker*

  225. #225 TBruce
    November 18, 2011

    blackheart:

    Still missing my single-layered reply. Oh hell, you can’t even find the cake. Guess the elephant in the house must have eaten it.

  226. #226 Prometheus
    November 18, 2011

    The latest comment from “Blackheart” (#223) appears to be nothing more than a cut-and-paste from Dr. Dhillon’s BMJ comment. Is that part of his multi-dimenional, transwarp, multi-layered multiverse?

    “Blackheart” (#212):

    “Changes were found in over 90% of the autistic children studied. 47/50 children. That’s a lot of pathology you are going to have to dismiss as ‘mysteriously’ disappeared.”

    Although he – once again – failed to give any clues as to the study he was “citing”, I think I’ve tracked down this obscure reference to the following paper:

    Wakefield AJ, Anthony A, Murch SH, Thomson M, Montgomery SM, Davies S, O’Leary JJ, Berelowitz M, Walker-Smith JA. Enterocolitis in children with developmental disorders. Am. J. Gastroenterol. 2000 Sep;95(9):2285-95

    Not only is this not “independent confirmation” of Wakefield’s findings, you’ll find the retraction of that article in the May 2010 edition of the same journal.

    “Blackheart” is missing the Elephant in the yard – the 1998 Lancet article by Wakefield et al is dead and has been dead for over ten years. We are only just now hearing the anguished howling and gnashing of teeth from the “vaccines-cause-autism” crowd because they thought – ’til now – that it only slept.

    Prometheus

  227. #227 Denice Walter
    November 18, 2011

    @ Prometheus:

    And I suspect that the whimpering will continue for many years to come. These people are *not* going away, tail between their legs. Not at all.

  228. #228 Matthew Cline
    November 18, 2011

    @Prometheus:

    Although he – once again – failed to give any clues as to the study he was “citing”,

    Well, of course he didn’t. It’s our job to try to figure out what the hell he’s saying, not his job to communicate clearly.

  229. #229 Chris
    November 18, 2011

    Hence, blackheart’s trademark style: Interllectualis masturbatio.

  230. #230 Prometheus
    November 18, 2011

    Denise Walter,

    I have no illusions that the death of their martyred study will do anything but stiffen the resolve of fantasy-based “vaccines-cause-autism-and-all-bad-things” advocates.

    “Blackheart” (#137):

    “Often I give multilayered or multidimensional answers that expand not only on the questions asked but those “not” asked ie implied or alternatively I feel would expand on the topic. I’m that sort of fellow.”

    “Blackheart” (#187):

    “It’s not a question of being ‘dumb’ it’s a question of thinking in more complex terms. Not everyone understands it and not everyone can practice it. I’ve discussed matters pertaining to this before in terms of fluid and crystallised intelligence.”

    After reading these Sheen-esque, self-aggrandising, post-bong-hit, pseudo-philosophical ramblings, I’m reminded of an exchange in that classic film, Apocalyspe Now (1979):

    Kurtz: “Are my methods unsound?”

    Willard: “I don’t see any method at all, sir.”

    Prometheus

  231. #231 Denice Walter
    November 18, 2011

    @ Prometheus:

    Oh, but think how much *more* fun you’d be having- in reaction to the aforementioned- if you had studied how children’s and adult’s various skills and level of functioning are discernible from examples of their writing.

  232. #232 LW
    November 18, 2011

    “The latest comment from “Blackheart” (#223) appears to be nothing more than a cut-and-paste from Dr. Dhillon’s BMJ comment.”

    I initially thought that *blackheart* was claiming to have done a review of the results, and that *blackheart* was explaining them. One could wish that the multidimensional intelligence of which blackheart is so proud included the use of quotation marks, blockquote, or references. But I guess being ignorant of such niceties is just part of blackheart’s awesomeness.

  233. #233 Prometheus
    November 18, 2011

    Denise,

    I had assumed that Blackheart’s writing “style” was due to the influence of acute-on-chronic cannabis intoxication. Is there more to be discerned from his writing than that? I’m intrigued.

    Prometheus

  234. #234 brian
    November 18, 2011

    “Autistic enterocolitis” as a hypothesis has been “mouldering in the grave” for nearly a decade. All that is left is to decide which of the members of the Wakefield group (if any) committed deliberate fraud and which members allowed themselves to be duped – separating the goats from the sheep, as it were.

    It’s interesting that Nick Chadwick, who — as a graduate student — was the member of Wakefield’s team at the greatest professional risk if he failed to toe Wakefield’s line, did stand up to Wakefield and asked not to be included as Wakefield’s coauthor on a paper that he believed was not supported by the data. As Fiona Godlee indicated, some of Wakefield’s other coauthors may not be so worthy of admiration.

  235. #235 Skind
    November 18, 2011

    Of course, the whole point of participating in a discussion is to add your own answers to questions raised and to submit that other points of importance need to be raised.

    This is done in order to facilitate arriving at a more refined – and hopefully more accurate – depiction of the subject under discussion. You may not agree with the other people in the discussion, but you’re at least trying to help them understand where your coming from.

    As such, one would expect discussion to include ‘multi-layered’ answers.

    What you’re trying to do and whether or not you’re any good at it are two seperate issues in any response.

    Blackhearts excuse for his brain-shudderingly poor ‘multi-layered’ answers basically amounts to claiming ‘I’m trying to have a discussion’.

    He should consider the possiblity that the reason why a few dozen loosely connected commentators have repeatedly argued that he is a piss-poor discussion partner may be because he is a piss-poor discussion partner.

  236. #236 blackheart
    November 18, 2011

    Prometheus

    Although he – once again – failed to give any clues as to the study he was “citing”, I think I’ve tracked down this obscure reference to the following paper

    Wrong…

    Perhaps you’d like to check posts #94 and #187

    But then who would expect a sheep to be able to read and understand the implications of an important piece of primary evidence in this issue.

    Not only is this not “independent confirmation” of Wakefield’s findings

    Wrong …

    John Walker-Smith if you don’t know why then you shouldn’t be posting on this subject.

    Not only is this not “independent confirmation” of Wakefield’s findings

    Wrong …

    It’s the physical evidence that corroborates.

    “Blackheart” is missing the Elephant in the yard – the 1998 Lancet article by Wakefield et al is dead and has been dead for over ten years.

    Wrong …

    I just read something written by the BMJ … unfortunately the implications of that article are not working out as ‘skeptiks’ had planned.

    There seems to be a very subtle change …

    We are only just now hearing … from the “vaccines-cause-autism” crowd because they thought – ’til now – that it only slept.

    Wrong …

    For some it’s never been about “Vaccines cause Autism”

    It may take you some time to get your head around that one .

  237. #237 blackheart
    November 18, 2011

    Skind

    Of course, the whole point of participating in a discussion is to add your own answers to questions raised and to submit that other points of importance need to be raised.

    It seems some of the points I have raised multilayered are taking people out of their ‘comfort zone’. The well evidenced response is flight or fight.

    This is done in order to facilitate arriving at a more refined – and hopefully more accurate – depiction of the subject under discussion.

    That would tend to be more plausible if there was not a continuing held belief amongst posters of what I ‘believe’ in this matter.

    Wrong assumptions have always been the default position.

    “You may not agree with the other people in the discussion, but you’re at least trying to help them understand where your coming from.”

    There are actually many common ground areas. Unfortunately it is not always possible to elucidate these when people are undergoing psychological stress.

    There is always the opportunity to ask relevant insightful questions.

    As such, one would expect discussion to include ‘multi-layered’ answers.

    Let’s set aside the word ‘mulitlayered as it seems to promote much “angst” and perhaps use the word ‘sophisticated’.

    What you’re trying to do and whether or not you’re any good at it are two seperate issues in any response.

    I’m always open to critical appraisal from objective peers. I am unable to see any here.

    Blackhearts excuse for his ….

    I’m not sure how your cognition ‘flipped’ then ? But it was an interesting phenomenon.

    …brain-shudderingly poor

    It’s interesting you use the phrase ‘brain shuddering’. It seems to indicate a reflection of your unconscious mind as you are taken out of your own psychological schema.

    amounts to claiming ‘I’m trying to have a discussion’.

    There’s an interesting assumption.

    He should consider the possiblity that the reason why a few dozen loosely connected commentators

    Self reflection …always a healthy thing to do.

    may be because he is a piss-poor discussion partner.

    How does that change the “intellectual paucity” of the responses.

    Two way street that communication thing.

  238. #238 Denice Walter
    November 19, 2011

    @ Prometheus:

    Sorry I missed your query above…
    In short, you can tell *volumes* from a person’s writing- not just education, general intelligence,or presence/ absence of SMI- *but* more intriguing capacities about human interaction/ communication and transformation of skills into more mature functioning post-adolescence.
    Does the person use language naturally and creatively? Do they take the audience’s ability into consideration? How abstract or complex are they? Problems with metaphors? Are they trying to convince you how absolutely brilliant they are *all the time*? Trouble keeping an even keel emotionally? Oh there’s lots more.
    Thus I am often entertained by reading articles or comments by pseudo-scientists and their supporters. I do serious work- laughter is therapeutic for me.

  239. #239 blackheart
    November 19, 2011

    Denice

    I think Prometheus is rather busy trying to work out how he made another simple error.

    I think we should console him by purchasing a Gift Certificate from Salem’s Psychic Centre.

    http://www.salempsychiccenter.com/handwriting_analysis.html

    Whilst I have your attention perhaps you’d like to offer up the scientific rationalism of your craft.

    I’m sure Orac would be fascinated. Anyone else want to chip in with some phrenology.

  240. #240 blackheart
    November 20, 2011

    TW

    That’s such an awesome response by the aptly-named blackheart; I’ll have to remember it.

    Thanks TW …just in case you do forget here it is again. It’s a sad day for the magicians.

    (With additional commentary – Just like one of those DVD extra things)

    My research review of the slides in 1998 has important differences with the routine diagnostic histopathology process:

    Clarifying what real eminent research pathologists do like Professors in teaching hospitals

    (Apologies to the ‘grunts’we need you too)

    Routine diagnostic histopathology …

    It’s routine they are looking for routine disease.

    Then there is a joint review by clinicians and pathologists …. additional clinical, endoscopic, radiologic, and laboratory data that has been obtained after the “diagnostic” biopsy has been reported

    Now we’re getting to real clinical work done encompassing all the clinical knowledge we have of the patient, a solid ecological diagnosis.

    It is not unusual for the clinical significance of microscopic observations to be reinterpreted and altered by this process, and it could be that the histological diagnostic interpretation subsequently has to be corrected.

    Nothing wrong here … just good clinical practice.

    Thus the purpose of my grading sheet observations in 1998 was not, could not have been, nor was it intended to conclude the final diagnostic assignment of colitis (which has to be made in the light of full clinical/endoscopic/radiologic/ laboratory data; and response to treatment)

    Anyone who attempts to make such a diagnosis from such limited material is in serious error.

    Therefore on the grading sheets “nonspecific” means: “this microscopical appearance doesn’t remind me of any particular disease entity”, and this is why in none of my grading sheet observations have I stated “colitis”.

    It’s not something I’ve seen before … what do my colleagues think. Especially three eminent gastroenterologists

    Bowel disease is not diagnosed by gut mucosal histopathology in isolation:

    It certainly isn’t and it would make you wonder why anyone would attempt to do so.

    I am of the opinion that the histological interpretation should never (or not very often) replace clinical judgement

    A senior clinical paediatric clinician / gastroenterologist takes into account and is knowledgable of every aspect of the patient. Therefore he uses his skills and expertise to make the call.

    “A final diagnosis can only be made with the full clinical information and a biopsy specimen should be reported as diagnostic only if full supportive clinical information is available.”

    Ouch….that’s gotta hurt.

    Thus, at the time of submission of the Lancet 1998 publication, with the limited supplementary information available to me

    I am just one eminent cog in a clinical team

    in the context of a comprehensive clinicopathological review by trusted clinical colleagues, the designated diagnosis of colitis seemed to me to be plausible.

    Case closed …thank you. No joking of course there’s more … but you’re not going to like it.

    ————————————————

    Gonzo’s Big Book of Magic Tricks isn’t working out so well….

  241. #241 Krebiozen
    November 22, 2011

    Blackheart,

    “A final diagnosis can only be made with the full clinical information and a biopsy specimen should be reported as diagnostic only if full supportive clinical information is available.” Ouch….that’s gotta hurt.

    Are you the only person here who doesn’t understand that Dhillon was explaining why he made a mistake back in 1998 when he didn’t have the full information? The routine hisotopathologists had the full supportive clinical information and they concluded the biopsies were normal. You are greatly out of your depth, and continue to make yourself look foolish.

  242. #242 Prometheus
    November 22, 2011

    Krebiozen,

    “Blackheart” would be out of his depth in a parking-lot puddle. On this and other threads, he has shown a consistent inability to grasp the salient points of the discussion.

    For example, Dr. Dhillon’s “explanation” that he couldn’t make a diagnosis of colitis (or enterocolitis) without the clinical information is either an attempt to explain how he got the diagnosis wrong (as you point out) or an effort to distance himself from the “autistic enterocolitis” claims of Wakefield.

    When I read Dr. Dhillon’s statement, it seems that he’s saying – indirectly – “You can’t blame me for the ‘enterocolitis’ nonsense because I never would have diagnosed enterocolitis based solely on histopathology.”. It is very clear that Dr. Dhillon isn’t defending a diagnosis of “enterocolitis”, as he admits he never had the “full clinical information” he now says is essential to make such a diagnosis.

    He does manage to avoid seeming to stab Wakefield in the back in his statement, “…in the context of a comprehensive clinicopathological review by trusted clinical colleagues, the designated diagnosis of colitis seemed to me to be plausible.” In other words, “I trusted them to make the diagnosis; it’s not my fault!”

    I feel sorry for Dr. Dhillon, because it seems likely that he was one of the sheep in this situation. He seems to have been guilty of nothing more than excessive enthusiasm and misplaced trust. He should have heeded the timeless words of Otter (Animal House, 1978):

    “You f**ked up…you trusted us!”

    Prometheus

  243. #243 blackheart
    November 24, 2011

    Krebiozen

    Are you the only person here who doesn’t understand that Dhillon was explaining why he made a mistake back in 1998 when he didn’t have the full information?

    Some very wishful thinking there.

    It was John Walker-Smith the clinical investigator, paediatric gastroenterologist and the one that ‘tallied’ all the clinical information that described the aberrant bowel disorder found in autistic patients.

    Are you suggesting that John Walker-Smith committed fraud ?

    I’m all ears …

  244. #244 blackheart
    November 24, 2011

    Prometheus

    I simply point out… it’s not Professor Dhillon’s job to make any diagnosis.

    But then again it comes as little to no surprise that you have made another simple error.

  245. #245 Julian Frost
    November 24, 2011

    Blackheart:

    It was John Walker-Smith the clinical investigator, paediatric gastroenterologist and the one that ‘tallied’ all the clinical information that described the aberrant bowel disorder found in autistic patients.

    It was also John Walker-Smith who was found guilty of gross misconduct and struck off alongside Wakefield.

  246. #246 Denice Walter
    November 24, 2011

    @ Julian Frost:

    Do you ever get the impression that we’re in a bizarre play or performance art piece? It’s almost funny. However how do we communicate with people who have a great deal invested in believing in the intregrity of a project and an individual neither of which hold water? For some reason, a sieve comes to mind.

    AJW’s project has been thoroughly eviscerated after being placed under the microscope. It’s not “just a journalist” but an additional series of events that include having his article re-tracted, being struck off by the GMC, failing to appeal, losing a court case ( and paying up), need I go on? Obviously those who argue in his support aren’t relying upon external reality but their *feelings*. His position- and persona- resonant with their own deepest beliefs and make them feel better about themselves.

    We can argue all we like but will not make any headway with the adamantly entrenched *but* there are people “listening in” and most of those aren’t adamant supporters of AJW- in fact I suspect that their sentiments are distributed normally- speaking to them isn’t an exercise in futility. In fact, I often raise my glass in appreciation of them.

    Our friend Blackie mentions my “craft”? And which craft is that, pray tell? I think he imagines that I am a psycho-therapist- wrong. I am a liberal arts person who managed to take about 20 courses in life sciences and another 20 in social sciences, continued grad work in social sciences, predominantly psychology ( the other is a secret- guess!) including a clinical sequence, focus on cognition, life-span developmental , statistics…. worked in counselling and other dark arts. SB psychology looks at people’s abilities, ways to develop them, and how they function in the real world.

    My only craft is being an “all court player”. Look it up.

  247. #247 blackheart
    November 25, 2011

    Denice

    Thanks for the update on your CV … it was well interesting.

  248. #248 Broken Link
    January 30, 2012

    In another interesting connection, this is posted on the FB page “Get Well Carmel” which is in support of Andrew Wakefield’s wife Carmel, who was apparently injured in a car accident. It seems that David Lewis, microbiologist and whistle blower is also an ordained minister, and is willing to accept money to help out the Wakefields:
    ___

    As a friend of the Wakefield family, I would like to thank all of you for your friendship to Carmel. They are going through an extraordinarily trying time. On top of this trauma, their daughter Imogen’s car was stolen from a park this week. Another friend, Dr. David Lewis, a research microbiologist and ordained minister has established a fund at his church for Andy and his family, to help with the added financial issues related to this accident. Anyone who would like to contribute can sent a donation to:———————————————
    Donations to Andy Wakefield Family

    Checks can be made payable to Saxon Road Church (Federal Tax ID EI 58-2083521) and mailed to David L. Lewis Saxon Road Church 1310 Saxon Road, Watkinsville, GA 30677.

    Saxon Road Church is a non-profit, non-denominational community church built in Oconee County, Georgia in 1993. It provides community services and accepts donations for specific needs. It does not take up offerings during services, which are held each Sunday from 11-12:00 AM EST. Church bylaws prohibit church staff and officers from being paid for any services rendered to the church. All donations to Andy Wakefield’s family will be paid out to Andy in full.

    David L. Lewis, CEO Saxon Road Church, Inc.

    Thank you – XOXOX

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