Andy Wakefield exonerated because John Walker-Smith won his appeal? Not so fast there, pardner...

I sense a disturbance in the antivaccine crankosphere.

Actually, maybe "disturbance" is the wrong word. Unabashed whooping it up is closer to correct. High-fiving is perhaps a better term. Or maybe partying like it's 2005. The question, of course, is what is the inciting event was that sparked such widespread rejoicing in the antivaccine world. I'll give you a hint. It has to do with the hero of the antivaccine movement, the man who arguably more than anyone else is responsible for the MMR scare that drove down MMR vaccine uptake in the UK to the point where measles, once vanquished, came roaring back. Yes, we're talking about Andrew Wakefield, whose incompetent and now retracted research launched a thousand biomedical quacks. (Actually, that's probably an underestimate.) However, we're not talking about Andrew Wakefield directly. Rather, we're talking about Professor John Walker-Smith, one of the co-authors of Andrew Wakefield's now rightly discredited 1998 Lancet paper. The anti-vaccine crank blog is going wild with the news that Professor Walker-Smith has succeeded in his appeal of the General Medical Council's decision that he should be struck off the medical record along with Andy Wakefield:

A High Court judge quashed the finding of professional misconduct against Professor Walker-Smith, who had carried out some of the tests for the controversial paper that suggested a link between the MMR vaccine and autism.

Mr Justice Mitting also called for the reform of the General Medical Council's disciplinary hearings after the lengthy battle by Professor Walker-Smith to clear his name.

The Wakefield paper prompted a nationwide scare over the safety of the jab after the study of 12 children was published in the medical journal The Lancet.

On AoA, we've been treated to some articles with titles like this:

The full ruling can be found here. Let's dig in, shall we? As usual, what the antivaccine movement is promoting and what is in the ruling are not necessarily the same thing. If there's one thing that's obvious from the outpouring of verbiage from various antivaccine blogs, Twitter feeds, and press releases, it's that the antivaccine movement somehow thinks that this decision exonerates Andrew Wakefield, too. Let's disabuse them of that delusion right now, shall we? According to Mr. Justice Mitting:

At a press conference, which Professor Walker-Smith did not attend, convened to accompany publication, Dr. Wakefield stated publicly the view which he had previously expressed privately to Professor Walker-Smith that he could no longer support the giving of MMR vaccine. The joint view of Professor Walker-Smith and Dr. Murch, stated in a letter to Dr. Wakefield on 21st January 1998, was that it was inappropriate to emphasize the role of MMR vaccine in publicity about the paper and that they supported government policy concerning MMR until more firm evidence was available for them to see for themselves. They published a press release to coincide with publication stating their support for "present public health policy concerning MMR". Dr. Wakefield's statement and subsequent publicity had a predictable adverse effect upon the take up of MMR vaccine of great concern to those responsible for public health. There is now no respectable body of opinion which supports his hypothesis, that MMR vaccine and autism/enterocolitis are causally linked.

Correct. There is no respectable body of opinion supporting Wakefield's hypothesis that the MMR is somehow linked to autism or the entity Wakefield made up called "autistic enterocolitis." It's rather annoying that Mitting would refer to it as a "body of opinion." One can only speculate that it's his legal background that leads him to use this particular phraseology. No scientist would. Scientists would (and do) point out that not only is there no good scientific evidence supporting Wakefield's hypothesis, but there is a lot of evidence that falsifies his hypothesis. There's a reason why Wakefield is viewed with such contempt in the scientific world. Actually, there are multiple reasons, not the least of which is that Wakefield is an incompetent scientist willing to commit research fraud to provide evidence for trial lawyers to use in lawsuits against vaccine manufacturers, a plot that Brian Deer uncovered and described in excruciating detail and with excruciatingly detailed documentation. This ruling says nothing about that; it's primarily about methodology and Mitting's legal ruling that the GMC didn't adequately explain the rationale behind its findings that Walker-Smith committed professional misconduct. Mitting's decision also relies a lot on his clearly poor understanding of medical research issues. (More on that below.)

It's a simple fact, though, that Mitting's decision regarding has nothing to do with whether Wakefield is a fraud or a pseudoscientist or not. Nor does it have anything to do with the question of whether vaccines, specifically the MMR vaccine, cause autism, as much as Wakefield's many apologists would like to convince people otherwise. In fact, as I've pointed out before, Wakefield's being struck off the British medical registry has nothing to do with the validity of the science. Even if Wakefield had prevailed and been allowed to keep his medical license, his claimed findings that vaccines cause autistic enterocolitis and/or autism would have been just as bogus. Legal rulings are not science. They can be based on science, but often they are not. It's nice when they don't go against science and nicer still when they resoundingly agree with science, but such is not always the case. To try to argue that a legal ruling such as the one regarding Professor Walker-Smith exonerates Wakefield is an even worse folly than arguing that his being struck off necessarily proves he is a quack. He's an antivaccine quack based on science; it matters not what the courts say.

Admittedly, I haven't paid much attention to Professor Walker-Smith. Back when I wrote about Andy Wakefield being struck off, I said very little, if anything about Walker-Smith. The reason, of course, is that I viewed the Walker-Smith decision as being at best peripheral. I didn't know enough about him to decide for myself whether the GMC decision was justified or not. Still, it's useful to look at the court's decision to see why it concluded that Walker-Smith didn't deserve to be struck off.

The first thing that needs to be considered is a dichotomy. John Walker-Smith appealed the GMC decision. Andrew Wakefield did not. Why not? It's hard to say. Was it because he was too busy being the medical director of the quack clinic Thoughtful House in Texas? After all, at the time he was already making plenty of cash without a medical license. There was no need for him to appeal, which would cost a lot of money and effort. He had already left England anyway, his reputation trashed long ago. In contrast, Professor Walker-Smith appears to have had more reason to fight. He had stayed behind and, unlike Wakefield, who had never been particularly respected, Walker-Smith had been highly respected in his field. There was a lot more motivation for him to try to salvage his reputation.

In any case, here is the conclusion of the appeal decision:

For the reasons given above, both on general issues and the Lancet paper and in relation to individual children, the panel's overall conclusion that Professor Walker-Smith was guilty of serious professional misconduct was flawed, in two respects: inadequate and superficial reasoning and, in a number of instances, a wrong conclusion. Miss Glynn submits that the materials which I have been invited to consider would support many of the panel's critical findings; and that I can safely infer that, without saying so, it preferred the evidence of the GMC's experts, principally Professor Booth, to that given by Professor Walker-Smith and Dr. Murch and by Dr. Miller and Dr. Thomas. Even if it were permissible to perform such an exercise, which I doubt, it would not permit me to rescue the panel's findings. As I have explained, the medical records provide an equivocal answer to most of the questions which the panel had to decide. The panel had no alternative but to decide whether Professor Walker-Smith had told the truth to it and to his colleagues, contemporaneously. The GMC's approach to the fundamental issues in the case led it to believe that that was not necessary - an error from which many of the subsequent weaknesses in the panel's determination flowed. It had to decide what Professor Walker-Smith thought he was doing: if he believed he was undertaking research in the guise of clinical investigation and treatment, he deserved the finding that he had been guilty of serious professional misconduct and the sanction of erasure; if not, he did not, unless, perhaps, his actions fell outside the spectrum of that which would have been considered reasonable medical practice by an academic clinician. Its failure to address and decide that question is an error which goes to the root of its determination.

As you can see, the decision all boils down to the question of research and whether Walker-Smith thought he was doing research or actually treating autistic children using interventions that were clinically indicated. If the interventions were clinically indicated, then it could be argued that he did not commit professional misconduct. If the interventions were done with the knowledge that they were being done for research purposes rather than to treat the children, then Walker-Smith is guilty of misconduct. The reasons, of course, are the lack of ethical committee approval yet, as is discussed in the decision:

At the heart of the GMC's case against Professor Walker-Smith were two simple propositions: the investigations undertaken under his authority on eleven of the twelve Lancet children were done as part of a research project - Project 172-96 - which required, but did not have, Ethics Committee approval; and they were clinically inappropriate. Professor Walker-Smith's case was that the investigations were clinically appropriate attempts at diagnosis of bowel and behavioural disorders in children with broadly similar symptoms and, where possible, treatment of the bowel disorders or alleviation of their symptoms. The GMC's case was that he was conducting research which required Ethics Committee approval. His case was that he was conducting medical practice which did not. Accordingly, an unavoidable and fundamental question which the panel had to answer was: what is the distinction between medical practice and research?

In light of this introduction, what follows is profoundly contradictory in that the judge acknowledges that what Walker-Smith did could be reasonably viewed as research, but exonerates him because it could also be viewed as therapeutic:

The panel made no express finding on this issue and cannot have appreciated the need to do so. It was not helped by the premise upon which the GMC's case was founded. There was a good deal of evidence, to which I refer in greater detail below, that Professor Walker-Smith and his team were undertaking what any reasonable body of medical practitioners would categorize as research - but also that he intended and genuinely believed that what he was doing was solely or primarily for the clinical benefit of the children. When such an issue arises, a panel will almost always have to determine the honesty or otherwise of the practitioner.

Justice Mitting then lists facts supporting and negating the proposition that what Walker-Smith was doing was research. I must admit, I find some of the "facts negating' to be questionable. Particularly bizarre was Mitting's listing of a fact that no parent other than one was required to sign the consent form in the proposals submitted to the Ethics Committee or in the revised form approved by it. Well, duh! That was part of the problem, now, wasn't it? You know? Doing research without having obtained adequate informed consent from the parents?

Also rather odd was Mitting's other reasoning that "none of the five clinicians involved in the investigation of the Lancet children who gave evidence to the panel considered that they were following Project 172-96." So what? The children's information and clinical histories ended up being used in Wakefield's Lancet paper. I suppose one could argue that Walker-Smith was an unwitting dupe of Andy Wakefield an therefore was not guilty of research professional misconduct, but, if that's the case, it's hardly flattering to Walker-Smith. it's also hard to imagine what clinical indications existed to subject these children to lumbar punctures. As a clinician, I always had a hard time figuring out how Wakefield, Walker-Smith, and the rest justified doing lumbar punctures on these children.

The implications of Mitting's ruling are frightening in their potential. Think about it. Basically, if his ruling stands, it's hard not to wonder whether it's open season on human research subjects in the UK. As long as the physician can construct a quasi-legitimate-sounding rationale that he can point to aside from a research protocol for doing research-related tests on human subjects, he apparently doesn't need to get ethical approval anymore. He can cite Mitting's ruling that, as long as he doesn't think he's doing research--even if that is incorrect--then he's not, and the GMC can't do anything about it. So much for the Helsinki declaration! Similarly, his "any reasonable physician" test fails spectacularly as well, at least in the way he applied it. "Any reasonable physician" would not subject autistic children to a battery of invasive tests including lumbar punctures for dubious clinical reasons. Those tests were quite correctly judged by the GMC to have been ordered for research purposes rather than for routine clinical care. Autism quacks in the UK have good reason to rejoice. As it stands, one has to wonder whether they can now get away with essentially anything.

Of course, none of this stops the antivaccine movement from lapsing into full mental jacket conspiracy mode. For instance, our old friend Ginger Taylor, speaking for the Canary Party, issued a press release:

"It is quite obvious to me that James Murdoch, Brian Deer and GlaxoSmithKline orchestrated the smear attack on Dr. Andrew Wakefield," said Ginger Taylor, executive director of the Canary Party. "A judge has now ruled that the GMC hearings were a farce. Parents are waiting for journalists to find their spine and start some honest reporting on the character assassination of doctors that is blocking medical treatments for vaccine injured children, and the role that GSK and Merck may be playing to protect their profits on the MMR vaccine. The Canary Party honors and stands by doctors of integrity like Prof. Walker-Smith, who continue to fight and defend their hard-won reputations for going the extra mile to investigate and improve the chronic, difficult-to-treat cases that now permeate our society."

Uh, no.

I do love the conspiracy mongering, though. From my perspective, Judge Mitting's decision strongly implies that, rather than being involved in Wakefield's professional research misconduct, Walker-Smith was an unwitting dupe. Neither conclusion speaks particularly well of Walker-Smith, but I suppose it's better to be an honest dupe than a dishonest research cheat. Personally, I'd rather be neither. No matter how hard the antivaccine movement tries to spin this as some sort of exoneration of its hero Andy Wakefield, it's not.

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Just want to add in my 2 cents worth as originally I was thinking of avoiding the MMR shot for my son but after all my research there is no such thing as absolute safety, there is only probability of risk. Vaccinations are not 100% effective - a tiny proportion of people vaccinated against a disease still contract the disease. It may also be that one in several million vaccinations will induce a serious side effect. It is equally true that the other several million vaccinations will produce no serious side effect but will ensure effective protection against disease. And thus without vacinating my son he is at significant risk of contracting a serious disease and that's more likely so than autism being triggered from the shot (whether there is truth to that or not).

BTW anyone who supports Wakefield is a muppet! How can you support someone who uses his sons's birthday party to obtain blood samples from children. He is completely unethical and deserves to be stricken!

@Gags - kudos for actually taking the time to do the research!

@Lawrence - Thanks, decisions should not be made without proper consideration and plenty of research :)

I don’t even know how I ended up here, but I thought this post was great. I don't know who you are but certainly you are going to a famous blogger if you aren't already ;) Cheers!

Very nice post. I just stumbled upon your blog and wanted to say that I've really enjoyed surfing around your blog posts. After all I will be subscribing to your rss feed and I hope you write again very soon!

I find Justice Mitting's reasoning quite flawed in many respects. This is just one of them:

He refers several times to the "Bolam" test, which say that someone is not acting with negligence if they are doing what any other reasonable and responsible doctor would do. He seems to have decided that the justification for doing these invasive procedures was sound, because the clinicians (ie WS) said so, but their justification for many of the later cases seems to be of the nature: "We suspect this child needs these investigations because we have already seen a few children who we have investigated and found they had something wrong with their bowels".

But we know that in no case was a lumbar puncture abnormal, and we know that the evidence for inflammation of the bowel was weak or non-existent in many cases (though at the time I can understand why the clinicians thought they might have been "onto something").

But Justice Mitting ignores the wider implications of his ruling. The pertinent question is "What would other resonsible doctors have done?" according to the Bolam criterion, and he fails to realise that faced with a child with autism (several of whom had aspergers rather than severe autistic problems) and bowel problems (which included constipation in at least one child, and which we know is extremely common in autistic children), that other pediatric specialists would NOT be referring these children for a battery of investigations including MRI head scans and lumbar punctures under general anaesthetic, colonoscopy with 10 biopsies, and barium meals and followthrough examinations.

There was nothing inherently unusual about these autistic children, except that their referral was engineered on the back of the MMR litigation.

Does Justice Mitting think autistic children need to undergo these tests then? If so, then the job to be in is clearly radiology or pediatric gastroenterology, since one child in 100 will need assessment.

The Bolam test also applies to clinical negligence, which is distinct from what might constitute "professional misconduct". No-one accused WS of being negligent in his investigation of these children, so why even bring Bolm into it?

From my perspective, Judge Mitting's decision strongly implies that, rather than being involved in Wakefield's professional research misconduct, Walker-Smith was an unwitting dupe.

Poor old Walker-Smith has hardly walked away with his reputation unsullied - he either didn't know (and should have done) what was going on with research he was co-operating in and lending his name to, or he was complicit in unethical practices. Judge Mitting has concluded that there was no evidence to contradict the former proposition.

It's important to understand the context of the decision - the Judge was not ruling on Walker Smith, he was ruling on the GMC's quasi legal processes. The Judge has no power to 'exonerate' Walker Smith, rather he has 'tried' the GMC and found its decision in the case of Walker Smith to be 'unmet', and further that in general, aspects of the GMC's procedures are unsatisfactory. The effect is that legally Walker Smith should not have been subject to the sanctions imposed upon him because the GMC preffered a weight of evidence which in Law, it was not entitled to do.

The decision does appear to leave UK medical research with a serious regualtory problem, that is: any clinician is absolved of the need to gain ethical approval for research, where all the research subjects are claimed to be recipients of necessary treatment - this in a circumstance where the clinician can claim protection of her/his own independent clinical judgement for the treatment prescribed. This is clearly open to abuse.

Successive UK Governments have failed to provide a modern legislative framework for medical registration and professional practice, the Walker Smith case is just another example of how inadequate the present system is.

IVI

If there's one thing that's obvious from the outpouring of verbiage from various antivaccine blogs, Twitter feeds, and press releases, it's that the antivaccine movement somehow thinks that this decision exonerates Andrew Wakefield, too.

Further than that: JB Handley thinks that this will somehow help in Wakefield's defamation lawsuit against Deer, even though the lawsuit is about an article which has nothing to do with the GMC hearings.

By Matthew Cline (not verified) on 07 Mar 2012 #permalink

Can you Hear The Silence,?? Orac your Blog reads as if you have been slapped in the face with a shovel.. Messiah Deer has spun you all lies by association and supporting his lies you are all implicatedâ¦Shame on you allâ¦

I see many articles/One time friendly Deer reporters now turning on Deer this one yesterday eh!get dug in..why dont ya!!

http://www.guardian.co.uk/science/the-lay-scientist/2012/mar/06/2

âBrian Deer's subsequent investigations were great journalism, but largely irrelevant to any scientific question about MMR; yet he seems to see himself as the hero of the story, once declaring in a bad-tempered Guardian piece that, "13 years passed before I slayed the MMR monster." The monster was long since dead of course, its twitching corpse dutifully held aloft by a legion of crappy hacks for St. Brian to stick his sword into.
The irony of Deer's pursuit of the MMR dragon is that it reinforced the mistaken belief that Wakefield and his study ever mattered in the first place. A debate that should have been about the weight of scientific evidence became instead a personality contest. Deer's investigation of Wakefield was informed by the same flawed world-view that led to the scare in the first place; the belief that personalities, bold statements and single studies matter more than evidence, context and consensus.â

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

Queerfish you have queered my pitch exactly. Thankyou. Your explanation completely supports the reason for Wakefield's defamation case against Deer and Godlee, namely that it is founded on fraudulent and more importantly, malicious allegations, against him personally.

@One Queer Fish:

Can you Hear The Silence,?? Orac your Blog reads as if you have been slapped in the face with a shovel..

The Unix word count utility "wc" clocks Orac's post at 2,480 words, which I'd hardly consider "silence". Or are you so used to Orac's wordiness that nothing less than 10,000 words will do?

I see many articles/One time friendly Deer reporters now turning on Deer this one yesterday eh!

In the article you link, the author doesn't say (or even imply) that Deer got any facts wrong about Wakefield's misconduct. Instead, the author criticized Deer for putting too much importance solely on Wakefield and not putting enough importance on the scientific consensus about MMR.

By Matthew Cline (not verified) on 08 Mar 2012 #permalink

@patricia:

Your explanation completely supports the reason for Wakefield's defamation case against Deer and Godlee, namely that it is founded on fraudulent and more importantly, malicious allegations, against him personally.

The BMJ article which deer wrote and the editorial which Godlee wrote weren't rehashings of the GMC hearings, so a GMC decision being overturned has no bearing on the defamation lawsuit.

By Matthew Cline (not verified) on 08 Mar 2012 #permalink

OQF: Your ramblings are somewhat in line of a global warming denialist who insists that it is "crumbling" - or indeed those of a quack or quack apologists who insists that [pick your euphemism for quackery] is the new wave of "Science" which is brushing aside the tired old ways. "Can you hear the slience" - really? What nonsense.

Why on Earth should we care what other journalists/columnists say about Brian Deer? Especially when they appear, as the one you have quoted does, to be entirely wrong?

Mathew cline

"The overturning of the GMC decision has no bearing on the defamation lawsuit...." I wonder about that.

Now that Brian Deer and his supporters have been utterly discredited - by bringing this malicious and entirely unfounded case to the GMC in the first instance - they are shown up for what they truly are, lackeys of a corrupt Public health authority and the pharma industry. Such actions don't exactly enhance their credibility in AJW's case I would have thought.

@patricia

Umm, patricia? Could you please point to anywhere in the judgment that states that Deer's reports are false or malicious? Again, if you'll note, the judgment is about Prof. Walker-Smith and the GMC. Or, more specifically, about how the GMC administratively went about their actions with regard to Prof. Walker-Smith. You seem to be reading far more into the judgment than is actually there.

@patricia: Obviously, you have reading comprehension problems, so I'll try to make this simple.

This does not mean Wakefield did not commit fraud in his research

All this means is that Professor Walker-Smith was found by the court to not have exceeded his authority (oops - big word - sorry) as a physician who performed procedures on the children.

It does not mean Wakefield didn't lie about the results, lie about the cause, or hide his own conflict of interest. It doesn't mean ANYTHING about the article Wakefield wrote that 10 of the 12 authors (including Walker-Smith) repudiated (oh dear, another big word. Sorry).

I don't think Dr. Godlee or Mr. Deer have anything to worry about, except maybe finding your bile disgusting. They certainly haven't been discredited. Try again, dear.

Todd
and MIDawn dear,

Where have I stated that AJW had been exonerated by this overturning of the GMC Tribunal conclusion? Only Orac has done that, my dear Dawn.

I have said that thw whole case should never have been brought in the first place. As indeed Judge Mitten has emphasised in his quashing of their verdict.

And I have said that it was only brought by the persistence of an "award winning" so called journalist and his supporters in the Government and in the pharma industry through malice and fear. Fear of profit loss and fear of the loss of credibiltiy on the part of the Governments Health department. The malice lies clearly at the door of a certain so called "award winning" journalist.

@patricia

Again, I ask, where in the judgment (available in full here) is there anything supporting your statement that "thw whole case should never have been brought in the first place"?

Just like there is nothing in there indicating that Deer was discredited or that his actions were malicious, there is nothing in the judgment stating that the actions by the GMC should never have been brought in the first place.

The judgment really is about how the GMC presented and supported its case, not whether it should have been brought.

"Fear of profit loss and fear of the loss of credibiltiy on the part of the Governments Health department."

Oh dear Patricia. You do realise that we in the UK have (just about) a National Health Service where everything is free at the point of use. What profits exactly?

By MissGrace (not verified) on 08 Mar 2012 #permalink

I'm confused - I thought Wakefield didn't matter? Why is AoA & the crank-sphere harping that this someone clears Wakefield? (I mean, I know why - the hypocricy is deafening).

Orac writes: "The first thing that needs to be considered is a dichotomy. John Walker-Smith appealed the GMC decision. Andrew Wakefield did not. Why not? It's hard to say."

I believe it was in the Mitting's decision that was written that W-S had insurance coverage to cover the High Court appeal, but Wakefield did not.

Anyone else see anything along those lines?

By Proscientifica (not verified) on 08 Mar 2012 #permalink

Another thing I note in the judgement - the case summaries for 10 children of the "Lancet 12" give the timelines between vaccination and development of symptoms of autism.

#1: Jan 94 to Nov 95 (22 months)
#2: Nov 89 to Feb 91 (15 months)
#3: Mar 91 to June 92 (15 months)
#4: not stated
#5: Apr 90 to Mar 91 (11 months)
#6: Jun 83 to May 94 (12 months)
#7: Nov 95 to July 96 (8 months - convulsions, child NOT autistic)
#8: Jan 95 to Jan 95 (2 weeks)
#9: Oct 91 to "mid 93" (20 months)
#10: Feb 94 to Oct 94 (8 months)
#11: not stated
#12: According to parent was 18-24 months later

What did Wakefield claim?

That for 8 children the average onset of autistic behaviours was only 6.3 days after MMR, enabling him to make a temporal link incriminating the vaccine.

There appears to be some major discrepancy.
I know that for some of these kids there may be an argument that symptoms were present from a time earlier than the first documented suspicion, but still....
We also know through Brian Deer's efforts that Wakefield heavily massaged the timeline data in the Lancet publication to arrive at a close temporal association, which supported his unwarranted notions about MMR.

@particia:

Such actions don't exactly enhance their credibility in AJW's case I would have thought.

Deer's personal credibility has nothing to do with a defamation case, as tried in Texas. Wakefield has to establish that Deer either knew or suspected that he was wrong about what he wrote in the BMJ article. And the BMJ article had nothing to do with the GwMC hearings.

I have said that thw whole case should never have been brought in the first place. As indeed Judge Mitten has emphasised in his quashing of their verdict.

So far as I can tell, the judgement written by Mitten said:

1) The GMC placed more weight on the expert testimony against Walker than the expert testimony for Walker.

2) The GMC failed to consider that Walker ordering a test for research purposes didn't preclude him also ordering the same procedures for medically indicated purposes.

Nothing about "thw whole case should never have been brought ".

By Matthew Cline (not verified) on 08 Mar 2012 #permalink

@Proscientifica

The only mention of Wakefield's appeal is this:

It ordered that the names of Dr. Wakefield and Professor Walker-Smith be erased from the register of medical practitioners. Both initially appealed, but Dr. Wakefield has subsequently abandoned his appeal.

The judgment says nothing of the reasons why Wakefield abandoned the appeal. Insurance is not mentioned anywhere in the decision.

AJW's supporters are whooping up a storm because they conflate issues, jump to un-warranted conclusions and dismiss evidence ( and people) they don't like- which appears to be their usual mode of thinking when writing about research et al.

Rather than going all psychological and looking at their motivations I think I'll just focus on one person. AJW had the opportunity to appeal and didn't. Think about it: if you were unjustly found guilty of something you didn't do, lost your professional status and were disgraced because someone made up stuff about you, wouldn't you appeal? Wouldn't you stand your ground? He comes from a well-to-do family, is married to a doctor, had friends and supporters- he's living in posh digs and raising funds now, as we speak- it can't just be money.

Also he could have sued the BMJ, Deer and Godlee in the UK. Why didn't he do that? Might have been easier legally. Maybe he figured that he couldn't win either case in the UK. Perhaps his present case is a way to garner attention and lift flagging interest in his cause.

By Denice Walter (not verified) on 08 Mar 2012 #permalink

Wakefield is still a fraud. Deer's reporting is still valid and helped to uncover that fraud thereby preventing harm to children the world over. W-S had no vaccine COI. Wakers did. Clearing W-S of poor judgement does nothing to move Wakers out of the cesspit he dug, filled and jumped in all on his own.

And another thing......

Justice Mitting displays incredible arrogance. The GMC fitness to practice panel was constituted from 3 medical experts and 2 laymembers. In the GMC panel documentation they commented that the Lancet article was aimed at general readership (ie general medical readership, rather than specialist gastroenterologists or another subspecialty)

What does Justice Mitting do, but erroneously assume because it was described as being for "general" readership that it was aimed at non-medical readers, ie people like him. He uses this to justify his own odd interpretation of what were the "consecutive referrals" of the Lancet children, rather than using the standard interpretation placed upon this phrase by practising clinicians.

"157 On the premise that the panel was right to find that the Lancet paper was addressed to the general reader and that it was the interpretation of the general reader which mattered, I am as well qualified as the panel to construe its meaning. Further, I am entitled to and do, apply the familiar canon of construction used by judges in construing documents: to read and construe the whole document, not just selected words. Thus construed, this paper does not bear the meaning put upon it by the panel. The phrase "consecutively referred" means no more than that the children were referred successively, rather than as a single batch, to the Department of Paediatric Gastroenterology. The words did not imply routine referral."

What arrogance and pomposity.

Sorry, Justice Mitting, but the entire Wakefield construct was that these were "routine", run of the mill patients consecutively referred by GPs and not pre-selected in any way.

This is what the GMC found:

First, in a published letter in response to correspondents who had suggested that there had been biased selection of the Lancet children, Dr Wakefield stated that the children had been referred through the normal channels, a response which was dishonest and irresponsible. He provided an inaccurate statement which omitted relevant information when he knew that the description of the population in the study was being questioned by the scientific community.
Second, at a meeting of the Medical Research Council, the Chair, Professor Sir John Pattison referred to the seriousness and importance of the implications of Dr Wakefieldâs research and its major public health implications. At that meeting and on the issue of bias in generating the series of cases, Dr Wakefield stated that the children had come by âthe standard routeâ, a response which was dishonest and irresponsible.

In the light of that evidence, Justice Mitting's conclusions about this seem bizarre, to say the least.

It is absolutely no surprise that AoA et al are reacting in this way to the news. It's completely consistent with their support of the entire vaccines-cause-autism notion, and their general approach towards expanding knowledge: if an item offers any support whatsoever, no matter how tenuous, for their premise, it is enthusiastically embraced. If it doesn't, it is either ignored or enthusiastically repudiated. If an item does both, its support is championed while the rest is totally ignored.

Never mind whether or not this decision had merit; it has absolutely zero bearing on Brian Deer, Wakefield's lawsuit against Deer, Wakefield being struck off, the merits of Wakefield's "research", etc. But they ignore that. They see everything through the filter of vaccines causing autism and a massive conspiracy to suppress that information; thus, everything they see is interpreted in that light.

By Calli Arcale (not verified) on 08 Mar 2012 #permalink

You all remember the case of the kid who Walker Smith declared should be "not for MRI or LP"?

Paradoxically, this fact was used to help exonerate WS. Justice Mitting stated that this demonstrated WS was acting in the interests of the child, and not fixed to a research protocol.

What happened?

The child, who was under WS's direct clinical care, ended up having an MRI scan and a lumbar puncture anyway. So who was to blame for that? Ummmm... no-one it would appear. We should just forget they ever happened. They weren't research, and nor was this action professional misconduct on the part of the clinician in charge of the case.

Welcome to bizzaro world.

I'll remember this little ruse anytime I want to do something unwarranted to a patient for any reason, such as underhand research. I'll just write in the notes "Don't pluck out Mrs Brown's left eyeball", and then quietly arrange for it to be done, and the eye sent to my friend's lab where he is doing eyeball research. When I appear in court, the fact that I expressly stated it should not be done will totally exonerate me from any blame or responsibility.

I have to say something about *malice*: if you look through alt med sites, that idea the medical establishment, the government and the media are compromised *malign* influences seems to be tossed around a lot. Getting closer to home, it appears to be a frequent taunt hurled at our esteemed ( and often steamed) host and many regular participants, yours truly included. Why is that?

If someone doesn't agree with you, does that make them malicious? How can you attribute personality traits and judge the worth of people you don't know? Is it possible that they may have come to a different conclusion than you did because they have a different perspective, different information and they *don't dismiss information* because they don't like the messenger?**

Alt med leaders engender distrust of critics to rally their own followers- how can you trust evil compromised miscreants? Looking closely at why people might support SBM ( not AJW) might reveal that they have reasonable concerns and are working towards fixing _something wrong that they saw on the internet_- that might hurt people.

** and JB doesn't like me: oh goody!

By Denice Walter (not verified) on 08 Mar 2012 #permalink

Clearing W-S of poor judgement does nothing to move Wakers out of the cesspit he dug, filled and jumped in all on his own.

I don't think W-S was even cleared of poor judgement. My reading of the judgement is that the GMC did not sufficiently explain their reasoning for finding him guilty of professional misconduct serious enough for him to be struck off.

I agree with Orac about the lumbar punctures not being clinically indicated. I was taught that an investigation is only clinically indicated if the results could lead to a change in the management of the patient. Fishing expeditions - doing a wide range of tests with no clear idea of what differential diagnosis you intend to confirm or exclude - are not considered to be clinically indicated, especially when a test is invasive and carries significant risks, like lumbar puncture. The potential benefits of an investigation must outweigh its risks.

I don't see how the results of any of the tests Walker-Smith ordered on CSF could have led to a change in the clinical management of a child with suspected autism, unless an underlying condition like meningitis was suspected, which was not the case. I don't see how the benefits of the CSF tests done could possibly outweigh the risks of lumbar puncture.

For example in research studies CSF from autistic patients has been examined and elevated cytokine levels have been observed. This is interesting, and has increased our understanding of developmental disorders, but doesn't change the way that autistic patients are managed. This would have required ethics committee approval and informed consent.

By this measure lumbar puncture in autistic patients can only be a research tool. It looks to me as if the judge didn't properly understand what "clinically indicated" means, and the important distinction between clinical practice and research in this case.

Whatever way I look at it, this makes Wakefield look even worse. He did not have the excuse of carrying out clinically indicated investigations as his contract forbade him from doing any such thing. Whatever tests he ordered or carried out were research, and required ethics committee approval which was clearly not the case.

By Krebiozen (not verified) on 08 Mar 2012 #permalink

It seems Deerâ only sings when he thinks he is winningâ gone to ground (eh! no surprise)..

Simply and firstly Dr Wakefieldâs paper never claimed a link between autism and MMRâ¦What it DOES report is a link between bowel disease and ASD. That finding still stands and is now endorsed by paediatric gastroenterologists worldwide. JWS and his team were the first to investigate and report on this. The GMC decision - which is now DISCREDITED - did untold damage to the continuing work on this issueâ¦it simply follows that Deer,Godlee and perpetrators of the lies and fanning the lies should be held to book, and kicked up the arse so hard they never sit down againâ¦happy days guysâ¦happy days a discredited GMC once again..

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

OQF@28:

QED.

Simply and firstly Dr Wakefieldâs paper never claimed a link between autism and MMR

His press conferences did.

What it DOES report is a link between bowel disease and ASD.

That he made up - the patients in question had no bowel disease.

That finding still stands and is now endorsed by paediatric gastroenterologists worldwide.

[citation needed]

JWS and his team were the first to investigate and report on this.

First to make up lies about it, you mean.

The GMC decision - which is now DISCREDITED - did untold damage to the continuing work on this issueâ¦it simply follows that Deer,Godlee and perpetrators of the lies and fanning the lies should be held to book, and kicked up the arse so hard they never sit down againâ¦happy days guysâ¦happy days a discredited GMC once again..

How exactly does a conclusion that Walker-Smith believed he wasn't doing research (all the ruling really says) have any of those implications?

So let me get this straight: Mitting's opinion states that Walker-Smith should have known he was doing research, but he is off the hook because he claims (plausibly enough to convince the judge, even though few doctors or scientists would be convinced) that he was treating the patients? That's definitely in exploding heads territory. And I agree with Orac about the consequence of this ruling: that it effectively guts any consent requirement for human subjects in the UK.

As for his "body of opinion" remark: Mitting is drawing an analogy between judicial precedents and peer-reviewed literature. There are some similarities between the two, e.g., reference points for explaining your reasoning to your peers (be they judges or scientists). But there are important differences: judicial precedents are often binding, but peer-reviewed research can be and sometimes is explicitly rejected when new evidence contradicts the earlier published result. I would say Mitting is mischaracterizing the peer-reviewed literature in a way that many people trained in law but not science would mischaracterize it.

By Eric Lund (not verified) on 08 Mar 2012 #permalink

The ruling clearly does not exonerate Wakefield. The key to the ruling is that judge felt Walker-Smith believed that what he was doing was primarily therapeutic and not research, but about Wakefield, the judge said this:

"Facts supporting the proposition
a) It was Dr. Wakefield who first perceived a link between behavioural and gastrointestinal disorders and between both and measles/measles vaccines. As a researcher, he was, throughout, principally interested in testing his hypotheses."

The High Court said the decision was âflawed, in two respects: inadequate and superficial reasoning and, in a number of instances, a wrong conclusionâ.

Ruling, Mr Justice Mitting stated: âThe panel had no alternative but to decide whether Professor Walker-Smith had told the truth to it and to his colleagues, contemporaneously. The GMCâs approach to the fundamental issues in the case led it to believe that that was not necessary â an error from which many of the subsequent weaknesses in the panelâs determination flowed.

âIt had to decide what Professor Walker-Smith thought he was doing: if he believed he was undertaking research in the guise of clinical investigation and treatment, he deserved the finding that he had been guilty of serious professional misconduct and the sanction of erasure; if not, he did not, unless, perhaps, his actions fell outside the spectrum of that which would have been considered reasonable medical practice by an academic clinician.

âIts failure to address and decide that question is an error which goes to the root of its determination.â

You lot have a brain cell between ya! yeah!!na!thought so just keep taking the pharma dollars trolls

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

One Queer Fish, could you please learn the English language before you post again?

By Gray Falcon (not verified) on 08 Mar 2012 #permalink

âIts failure to address and decide that question is an error which goes to the root of its determination.â

Wow, what a ringing exoneration! So the GMC made the error of ruling on the factual basis that Prof. Walker-Smith carried out research under the guise of therapy, without considering the possibility that somehow Prof. Waler-Smith might have actually believed that there was a therapeutic rationale.

Todd
Once again you have twisted my words. I did not write that Judge Mitten in his conclusion said that the case should not have been brought. I stated that by overturning the GMC's ruling and by finding it full of "errors, misstatements and inadequate reasonings", he emphasised my belief that it should never have been brought in the first instance.
It was Deer's twisted interpretations and flawed research which led directly to the GMC's faulty case. And as the case against Prof JWS has been judged to be full of holes - it can justifiably be said that the case against the other 2 doctors could well have been similarly exposed during appeal by them. As to why AJW did not appeal I have covered this over and over before on this site. But to reiterate in brief. AJW was advised by his Attorny's to drop his case against Deer (insufficient time to prepare)and that proved to be extremely costly, as a consequence of which his insurers would not/could not, fund another even more costly appeal against the GMC decision, which in point of fact would have been a case against the Government and the Pharma industry, all rolled into one neat little ineffectual, easily manipulated umbrella Institutional vehicle called the General Medical Council.

I think it is Denice who appears to be also under the illusion that because Andrew Wakefield is in her words "posh" - then he is automatically also extremely wealthy. I wish. And no doubt so does Andrew.

Miss Grace

I am a UK citizen. And I do know about th good old NHS. The Profit I was referring to was that of the Pharmaceutical Industry who have a massive influence and vested interest in all cases involving vaccine injury.

Mathew cline

Godlee and Deer are being sued for defamation, slander (a nasty one IMO) and libel, heinous libel in fact. Well if that isn't all wrapped up in malicious intent(my words not the Judge's) I don't know what is babe. I would have thought this GMC case, which was wholly instigated by Deer and his employer's and which has now been oveturned pronto by a High Court for being basically unsound, doesn't exactly bode well for Deer's credibility.

That's all folks.

OQF has to be a Poe-troll. No way someone can directly cite the ruling like that (assuming that this is, in fact, what he is doing) and fail to realize this has nothing whatsoever to do with Brian Deer or Andrew Wakefield.

Right? Right?

Now I just had an exceedingly crappy, awful thought: although the outcome for JW-S has no bearing on the fate of AJW, I realise that not all people think like I do- those who link vaccine and autism ( and AJW fans) might interpret the result as a harbinger of advantageous events to come- is it possible that this ruling may in-directly assist in enriching the coffers of the Andy Fund? While many people may support underdogs, don't others like to bet on whomever they perceive as being likely to win- like in a horse race? I'd love to see a dated graph of contribututions in 2012.

By Denice Walter (not verified) on 08 Mar 2012 #permalink

just keep taking the pharma dollars trolls

I've heard of all kinds of trolls, but I've never heard of a pharma dollars troll. Or is our genius (who has more than one brain cell between her) missing a comma here and there?

Compose99

Wrong! Wrong!

You none of you get it do you. It is NOT that AJW has been exonerated by this case being overturned. It is that the case (which was aimed at discrediting all 3 doctors) has been found to be built on unsafe and unsound and inadequate and mistaken foundations. That finding is enough simply to discredit the GMC Tribunal altogether. It cannot stand.

And for those who still cherish the idea that the Lancet children were all fixed cases - as someone else poetically put it - drink this in folks!

"It is in its findings on the clinical issues of the Lancet children that the most numerous and significant inadequacies and errors in the determination of the panel occur. In no individual case in which the panel made a finding adverse to Prof. Walker Smith did it address the expert evidence led for him, except to misstate it. The issues to which this evidence went, were of fundamental importance to the case against him. Universal inadequacies and some errors in the panel's determination accordingly go to the heart of the case. They are not curable....the panel's determination cannot stand".

@ Eric Lund

So let me get this straight: Mitting's opinion states that Walker-Smith should have known he was doing research, but he is off the hook because he claims (plausibly enough to convince the judge, even though few doctors or scientists would be convinced) that he was treating the patients?

It's my reading, too. In short, Mitting ruled that the GMC failed to provide evidence enough of the doctor's guilt.

If I was merciful, I would say everyone deserves the benefit of the doubt. It is, after all, the basis of a fair trial - innocent until proven guilty.

If I was mean, I would file this case in-between Dominique Strauss-Kahn ("I didn't assaulted this woman, it was consensual") and Richard Virenque ("Illegal drugs were given to me without my knowledge or my own will").

By Heliantus (not verified) on 08 Mar 2012 #permalink

Patricia (dear)...you already "tried" these same arguments at LB/RB and you were already told that your "arguments" on behalf of Wakefield have nothing to do with W-S's court case.

Your continued support of your *hero* and the reasons "why Wakefield didn't appeal the GMC ruling" were shot down at LF/RB...

"Denice you ask why AJW didn´t appeal. The answer is twofold.

a)He didn´t have the funds to do so. He was advised to drop a suit for defamation against Brian Deer as there was insufficient time to prepare for his defence. As a result of the Judge´s decsion not to allow his counsel to persue this defamation case, (it was a very costly decision), AJW´s insurance would not fund an appeal against the GMC decision to remove his licence to practice in the UK.

b) Of equal importance in deciding not to appeal was the fact that he did not need the accreditation to practice in a clinical capacity; his work is in research in an academic capacity (and had been for many years), unlike Prof JWS."

BTW, "dear", which reputable research institute would ever employ a physician whose license was revoked due to serious medical misconduct?

I see that the OQF Troll is back...with his brain droppings and his feeble attempt to derail this thread.

@patricia

You have a bit of spittle still on your lip. Now, do you care to actually address any of the points that I made in response to you, rather than some straw man blather you think I said?

he GMC's case was that he was conducting research which required Ethics Committee approval. His case was that he was conducting medical practice which did not. Accordingly, an unavoidable and fundamental question which the panel had to answer was: what is the distinction between medical practice and research?

Which begs the question, why did the Lancet authors claim they had ethics approval?

"Investigations were approved by the Ethical Practices Committee of the Royal Free Hospital NHS Trust"

The paper includes subheadings "clinical investigations" and "laboratory investigations". Were these approved or not? The paper doesn't say, "we didn't need ethical approval because these were all clinically indicated".

His hospital considered this work a research project. Ari Zuckerman at the Royal Free wrote a letter to Prof. Walker-Smith

I am reassured that the children with autism are investigated according to the clinical need and their clinical management. Nevertheless, it would be prudent to obtain ethical approval if, as I understand it, Andy Wakefield is collecting cases for report by publication, which is therefore a research project

Todd
I did answer in great detail but that post never made it to the site. I don't know where it went. I shall try to rewrite it if I can find the impetus and the energy. I may have left out my address details.

Didn't know you cared Todd....

"That finding is enough simply to discredit the GMC Tribunal altogether. It cannot stand."

If that were true, why are only 10% of appeals granted? If the court finds that the GMC is corrupt or whatever other label you wish to use, why are so few appeals being granted?

Frankly I would expect people to trumpet the fact that the court allows so few appeals through.

The court certainly thinks the GMC needs to change procedures. But "it cannot stand" is an amazing stretch. Likewise "discredit altogether".

Just to say that the Lancet Paper should now be reinstated pre-GMC decision .Richard Horton , he took the decision without discussion with authors after the GMC decision was made public to remove the paper. It would be entirely appropriate I think - to demand he takes action now to reinstate the paper and issue an apology. I note the attacks on the messengers rather than on the subject matter â¦very commendable and true to PHORM, pharma trolls more dollars please Pharma âwhat a good job I just didâ..pat on the back ...or a shovel in the face from me..

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

@Heliantus

It's my reading, too. In short, Mitting ruled that the GMC failed to provide evidence enough of the doctor's guilt.

Slightly more nuanced than that I think. It was more to do with the balance of evidence and that the GMC tribunal failed to give adequate weight to Walker Smiths's own claims (which he was qualified to make as a clinician), and that therefore the Tribunal was wrong to determine that the evidence weighed against Walker Smith to the degree that would allow the test of 'beyond reasonable doubt' to be made for the charge of professional misconduct to have been met.

One of the very unfortunate consequences of the judgement is that it effectively approves of collusion between parents and clinicians in subjecting vulnerable children to unnecessary investigations where the parents are determined tests are needed and the clinician finds it advantageous in providing research material under the guise of clinical need. It might be considered to border upon a charter to accede to Munchausen's By Proxy vicariously delivered by iatrogenia.

My esteemed Lilady

No one has "shot me down" on LBRB as you so graphically put it. I must say your name suits your literary tone. Shades of the saloon bar?

You ask "what reputable research institute would ever employ
a physician whose license had been revoked due to serious medical misconduct?" Someone who has unbounded admiration for a man who was prepared to put his head above the parapet in a high profile battle zone, a man who was even prepared to flush his own career down the toilet, (Wakefields own words not mine), in order to stand by his belief in the necessity for safe vaccines in an unsafe world of profiteers and politicians with vested interests, perhaps?

Now that is what ah too would call a real man Lilady!

Regarding lumbar punctures (LPs), I was taking a look around to see when an LP is clinically indicated. Generally, it is to confirm a bacterial, viral or fungal infection due to a diagnosis of meningitis, encephalitis or syphilis; to help with a cancer diagnosis; or to get more information on an inflammatory condition of the central nervous system. I was not able to find anything indicating that it is standard of care for treating gastrointestinal disorders, nor is it indicated for the diagnosis or treatment of autism spectrum disorders.

Wakefield and company were investigating a new, never-before-seen diagnosis and were gathering data to investigate and prop up that diagnosis. By definition, that means that any LP would be for research purposes, rather than clinical necessity. I could, of course, be wrong in my assessment of the standard indications for LPs and welcome a physician knowledgeable in such procedures to correct me, but, as Orac and others already noted, it seems that Justice Mitting erred with regard to any of the LP bits.

While there are many questions I would like to ask JWS in the presence of Judge Mitting, there is one question that gets to the heart of the GMC decision. What was the justification for doing LP's (not to mention MRI's and bowel biopsies) on autistic children? The answer: there is none ... other than speculative research. That being the case, it is quite clear that JWS knew that these tests were for research and not treatment. There is no medical justification for the tests done on these children and I find it hard to believe an IRB approved this research. This is not as the the judge would have you believe, a matter of mindset. There is no way JWS believed what he was doing was therapeutic or anywhere approaching the standard of care for autism evaluation or treatment.

By Moderation (not verified) on 08 Mar 2012 #permalink

L.P.`s who is talking about that.. the position should at least revert to where it was prior to the GMC findings and which it has been tested very thoroughly by Judge Mittingâ¦you can`t argue with a decision from a High Court Judge it is the highest law in the UKâ¦you lot need a reality check with non Pharma earth one day soon..

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

for those who claim this appeal exonerates Mr. Wakefield, I suggest you look at the GMC findings. Specifically, look for those charges which were found to have been "serious professional misconduct".

The costing proposal set out costs in respect of the investigation of five children. It covered each childâs four-night stay in hospital with colonoscopy, MRI and evoked potential studies. Dr Wakefield admitted that the funding subsequently provided by the Legal Aid Board had not been needed for these items because these costs were borne by the National Health Service as the patients were being admitted as NHS patients.

The Panel found that Dr Wakefield had a duty to disclose this information to the Legal Aid Board via Mr Barr. It was dishonest and misleading of him not to have done so. The Panel concluded that his intention to mislead the Legal Aid Board was sufficient on its own to amount to serious professional misconduct.

With regard to nine of the eleven children (2,1, 3, 4, 6, 9, 5,12 and 8) considered by the Panel, it determined that Dr Wakefield caused research to be undertaken on them without Ethics Committee approval and thus without the ethical constraints that safeguard research. Ethical constraints are there for the protection both of research subjects and for the reassurance of the public and are crucial to public trust in research medicine. It was in the context of this research project that the Panel found that Dr Wakefield caused three of these young and vulnerable children, (nos. 3, 9 and 12) to undergo the invasive procedure of lumbar puncture when such investigation was for research purposes and was not clinically indicated. This action was contrary to his representation to the Ethics Committee that all the procedures were clinically indicated. In nine of the eleven children (2,1, 3, 4, 9, 5,12, 8 and 7) the Panel has found that Dr Wakefield acted contrary to the clinical interests of each child. The Panel is profoundly concerned that Dr Wakefield repeatedly breached fundamental principles of research medicine. It concluded that his actions in this area alone were sufficient to amount to serious professional misconduct.

In regards to his connection with work with the Legal Aid Board (LAB) for funding and his work with the litigation, the GMC found that Mr. Wakefield should have revealed his involvement to the ethics committee at his hospital:

However, given the importance of an Ethics Committeeâs reliance on the probity of an applicant, the Panel determined that this was a failure by Dr Wakefield and his actions amounted to serious professional misconduct.

In terms of his patent:

Dr Wakefield was insistent that his involvement with the new patent had not given rise to any prior need to disclose. Despite the clear terms of the patent, he did not accept that the invention was envisaged as an alternative vaccine to MMR. He acknowledged that he had envisaged the use of transfer factor for at least a proportion of the population and that he had a financial and career interest in its success, but he said that it did not cross his mind to disclose it, and even with hindsight he insisted that there was a reasonable argument, as he put it, for non-disclosure. The Panel considered that his actions and his persistent lack of insight as to the gravity of his conduct amounted to serious professional misconduct.

In regards to his work with the "transfer factor", where child 10 was given this "therapy".

Dr Wakefieldâs actions were contrary to the clinical interests of Child 10 and an abuse of his position of trust as a medical practitioner. The Panel considered these to be serious departures from the standards of a registered medical practitioner and concluded that these amounted individually and collectively to serious professional misconduct.

With regards to the famous birthday party blood draw:

Dr Wakefield defended the ethical basis for the taking of blood at a birthday party contrary to the experts who gave evidence to the Panel and who strongly condemned this action. The Panel determined that his conduct fell seriously short of the standards expected of a doctor and was a breach of the trust which the public is entitled to have in members of the medical profession. It concluded that this behaviour amounted to serious professional misconduct.

There isn't much overlap between those findings and those of Prof. Walker-Smith. Even if one throws out the charge of performing test not clinically indicated for research purposes (parts of which I believe would likely still stand. For example, calling for tests when he did not have clinical responsibilities), Mr. Wakefield still would have been found guilty of "serious professional misconduct".

BTW Todd

I do not have any spittle on my lip. That is not a very nice thing for a gentleman to say to a lady.

I will now attempt to summarise my lost post.

Did the judge say anywhere in his judgement that the case should never have been brough to court? Answer No, he did not. And I never stated otherwise. I did however say that as he had proclaimed in his Judgement that the case was full of "errors, inadequate reasonings and wrong conclusions" I said that this view emphasised my belief that the case as such, should never have been presented in the first place. It was an unprofessional and wholly inadequate case presented by a bunch of amateurs with insufficient legal expertise. Oh, and since the whole case had been perpetrated in the first instance solely by Brian Deer and his cohorts, it therefore challenged their credibility in pursueing their twisted and wrongful interpretation of events. My words not Judge Mitten's.

Have I missed out stuff?

@One Queer Fish:

Just to say that the Lancet Paper should now be reinstated pre-GMC decision

The Lancet's editors on the retraction:

... it has become clear that several elements of the 1998 paper by Wakefield et al1 are incorrect, contrary to the findings of an earlier investigation. In particular, the claims in the original paper that children were "consecutively referred" and that investigations were "approved" by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record.

Neither of those two things (consecutive referrals or ethics committee approval) were contradicted by the judgement, so The Lancet has no reason to undo the retraction.

By Matthew Cline (not verified) on 08 Mar 2012 #permalink

Moderation,

there is much discussion of lumbar punctures on day 13 of the GMC hearing transcripts.

He was able to produce a number of papers using lumbar punctures. Except they were all research projects.

Q You were asked particularly about the lumbar punctures. You have made it clear to us that it was not your decision that they should be included, but Mr Miller particularly asked you about a Medline search that you had done as to whether lumbar punctures were done on children with autism and you said that you had, indeed, done that and you have turned up some results. You referred in particular to Gilberg, is that correct?
A And I think I have shared those results with the GMC solicitors.

Q Yes, you did indeed. Those were all research projects, were they not?
A Yes. (Pause) I should not try to defend the lumbar puncture because I was not the person who tried to order it. What I am trying to defend is the logic that might lead a doctor, listening carefully to parental concerns, to conclude that a lumbar puncture is a worthwhile investigation. But it is not for me to say lumbar punctures were indicated. I am thinking more about the inherent logic and whether we use that sort of logic in ordinary practice.

The Royal Free doesn't do them as a rule for autistics:

"We do not, in child psychiatry at the Royal Free, do lumbar punctures in our assessment of an ordinary child with autism without any other clinical hypothesis. "

http://wakefieldgmctranscripts.blogspot.com/2012/01/day-13.html

patricia:

In your reply to me you cite part of the ruling, a part which appears to be carefully snipped either by yourself or by your source (Age of Autism, perhaps?). Let me quote the full section:

It is in its findings on the clinical issues in the individual cases of the Lancet children that the most numerous and significant inadequacies and errors in the determination of the panel occur. In no individual case in which the panel made a finding adverse to Professor Walker-Smith did it address the expert evidence led for him, except to misstate it. The issues to which this evidence went were of fundamental importance to the case against him. Universal inadequacies and some errors in the panel's determination accordingly go to the heart of the case. They are not curable. Unless the remainder of the panel's findings justify its conclusion that Professor Walker-Smith was guilty of serious professional misconduct, its determination cannot stand. [Emphasis mine]

The section of the ruling you are clearly misrepresenting specifically pertains to the GMC panel's findings against Walker-Smith.

It also seems fairly clear in the judge's ruling that Walker-Smith had serious reservations about aspects of Wakefield's behaviour (as per his communications to Wakefield regarding the litigation in-progress, noted in paragraph 6 of the ruling and his & Dr Murch's letter to Wakefield expressing their concerns over his publicity regarding the 1998 paper as noted in paragraph 7).

So I am confident that my conclusion about the ruling not being applicable to Wakefield's GMC ruling or Brian Deer's investigations stands.

Just to say that the Lancet Paper should now be reinstated pre-GMC decision .

All the justice found was that the GMC did not have sufficient evidence to conclude that Walker Smith believed he was undertaking research in the guise of clinical investigation and treatment. That's all. That fact isn;t sufficient to require Lancet reverse it's retraction of the publication, in light of the facts that

1: 10 of the paper's 12 co-authors of the paper have requested its retraction

2: Wakefield demonstrably committed scientific fraud by misrepresenting or otherwise altering the medical histories of all 12 of the subjects the paper addresses (five of which showed developmental problems before receiving the MMR vaccine and three of which never were diagnosed with an autism spectrum disorder)

3: Wakefield failed to inform the Lancet's editors of serious conflicts of interest (the fact he was being paid by lawyers to manufacture evidence to support of a class action suit, the fact that having patented an alternative vaccine and incorporated a company which he would have accrued considerable financial gains if confidence in the existing MMR vaccine's safety were undermined, etc.)

This ruling and some of the comments on this blog, especially patricia's, illustrates the profound disconnect between the point of view of science (or at least working scientists and those who try to use science in their daily work like physicians) and the law (which is more familiar to journalists like Brian Deer and the general public).

I keep thinking back to Dr Paul Offitt's comment after Dr Andrew Wakefield was struck off by the GMC. He said (if I remember correctly) words to the effect that: from the point of view of science, it doesn't matter if Wakefield's work was fraudulent, the science was wrong.

That is, well done research after the Lancet paper had failed to confirm Wakefield's results showing that those results were most likely incorrect. Whether they were honest or fraudulent was irrelevant to whether the results were correct.

A scientific assessment of how reality works is based on a consensus of experimental results which are consistent with each other. It doesn't stand or fall based on any one experiment.

However, a legal assessment of guilt (which is what the general public sees every night on TV crime shows) depends on a lot of separate pieces of evidence all fitting together to show proof of guilt beyond a reasonable doubt. If one or two of those pieces of evidence are removed from the puzzle (whether they are incorrect, misinterpreted or just fail to meet legal standards to be admitted as evidence), the case to prove guilt may collapse.

This can be seen in the efforts of those who support the vaccine-autism link. There has been very little effort to do good research to prove the scientific truth of that link (and what has been done is mediocre at best). Wakefield himself declined to try to do that.

Instead there are lots of attacks on individuals like Paul Offitt, Brian Deer and Paul Thorsen with the hope that this will show that their evidence against the vaccine-autism connection (or Andrew Wakefield) is wrong, hence exonerating Andrew Wakefield, hence proving the truth of the Lancet paper, etc.

Their argument is a giant house of cards, but they keep trying to build it up anyway.

For more discussion of the science versus fraud angle, I suggest these two blog posts from a year ago in January:

http://scienceblogs.com/insolence/2011/01/misdirected_criticism_by_some…

http://scienceblogs.com/insolence/2011/01/british_science_accused_in_th…

And for a follow-on discussion of the issues in coping with fraud in science, I suggest these posts from last August:

http://scienceblogs.com/insolence/2011/08/in_which_i_disagree_with_bria…

http://scienceblogs.com/insolence/2011/08/scientific_fraud_and_journal_…

By squirrelelite (not verified) on 08 Mar 2012 #permalink

"We wish to make it clear that in [the 1998] paper no causal link was established between MMR vaccine and autism as the data were insufficient. However, the possibility of such a link was raised and consequent events have had major implications for public health. In view of this, we consider now is the appropriate time that we should together formally retract the interpretation placed upon [the] findings in the (1998) paper, according to precedent."

from Retraction of an Interpretation by Simon H Murch, Andrew Anthony, David H Casson, Mohsin Malik, Mark Berelowitz, Amar P Dhillon, Michael A Thomson, Alan Valentine, Susan E Davies, John A Walker-Smith (10 of the original 12 authors; John Linnell could not be reached)

Do read the subject matter before comment please..

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

All this can easily be cleared up. JWS can come out and give his medical justification for LP's, MRi's and bowel biopsies. All these evaluations have very specific indications, and if JWS believed he was preforming a therapeutic evaluation, he can easily give the indication for their use. If he cannot then the GMC was right to discipline him.

By Moderation (not verified) on 08 Mar 2012 #permalink

@ Patricia dear, you just shot down your own argument about why Wakefield didn't appeal the GMC decision...and inadvertently shot down Wakefield's pending lawsuit against the BMJ, Godlee and Deer, claiming defamation and loss of potential earnings.

What are the clinical indications for performing a lumbar puncture, dear?

"Now that is what ah too would call a real man Lilady!"

Now that is what I would call a disgraced former practicing physician, dear.

-FTFY

@OQF #53:

you can`t argue with a decision from a High Court Judge it is the highest law in the UK

The Court of Appeal and the Supreme Court are both able to overturn High Court decisions. But then you've already demonstrated you know nothing and are unable to do even basic research.

@patricia

Your story seems to be morphing. You said

Did the judge say anywhere in his judgement that the case should never have been brough to court? Answer No, he did not. And I never stated otherwise.

Yet the bit I was responding to, you stated:

I have said that thw whole case should never have been brought in the first place. As indeed Judge Mitten has emphasised in his quashing of their verdict.

Earlier, you also stated this:

Now that Brian Deer and his supporters have been utterly discredited - by bringing this malicious and entirely unfounded case to the GMC in the first instance - they are shown up for what they truly are, lackeys of a corrupt Public health authority and the pharma industry.

You have yet to show anywhere in Justice Mitting's decision that Deer's work was "entirely unfounded" or malicious or that what he found has been discredited. As I pointed out before, this ruling is primarily about how the GMC went about its work and the conclusions drawn from the evidence as it relates to Prof. Walker-Smith; it says nothing about the evidence itself, nor does it really address Prof. Walker-Smith's innocence or guilt.

Let me put it this way: suppose a man robbed a bank. The police put together a case, charge the man and bring him to court. They present their evidence, and the judge convicts the man. He appeals, and the appeals court finds that the evidence that had been presented did not rise to the level of "beyond a reasonable doubt". The appeals judge overturns the conviction and the man is free to go. Nothing has changed the fact that the man did in fact rob a bank. The appeals ruling is an indictment of the shoddy work of the police and attorneys general, but does not actually address the real guilt or innocence of the man.

Justice Mitting's ruling is along these lines.

The retraction of the interpretation is often misquoted as being most of the authors disowning the paper (as posts above) . The data within the paper holds true. Wake up call for you Pharma whoresâ¦

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

Denice has a theory that being "posh" means you are also automatically wealthy. I wish.

There is no doubt in my mind that Andy Wakefield unleashes in some people a tsunami of jealousy and resentment. Just for being educated, erudite. And so they absolutely revel in his downfall and cannot get enough of it.

Couldn't be because he is also goodlooking and nice could it? No. Course not.

I have a comment on the legal/scientific issue in moderation.

Meanwhile, for those who make think a lumbar puncture is just another medical test which is a nuisance but no real harm done, I will offer an illustrative anecdote.

I have been medically diagnosed with a seizure disorder for 35 years now. Fortunately, it is relatively minor and well controlled by medication.

However, in order to diagnose that condition and decide on an effective treatment plan, I have had two lumbar punctures or spinal taps. The second one, about 20 years ago, went fairly easily. Medical testing technology had improved and they didn't need to draw very much fluid and there were no significant ill consequences.

The first one was quite the opposite. I was advised beforehand that removing the spinal fluid would cause stress on the ganglia(?) that support the brain and might cause a severe headache and that I should lie still for 24 hours and not move or raise my head. (I wonder how you would get an autistic child to comply with that?) But, I did that after the procedure on a Friday. Saturday I felt all right and started raising my head and sitting up for a while. Then I started getting headaches, which got worse and worse and worse. And pain medication had to be authorized by a doctor, most of whom were gone for the weekend and no one seemed to figure out that I might need it on a regular basis. I think I talked them into giving me something 2 or 3 times. By Monday, the headache was still excruciating and I was driven to a commercial airport for a flight home. I didn't have money or time to buy medicine and missed a flight connection and had to wait in an airport for several hours waiting for the next flight and trying to rest my head on the awful airport "couches".

Finally, I got home and could buy some aspirin and really lie still on a comfortable bed and start to recover.

This is only an anecdote, and the probability of such a severe side effect is probably low.

Perhaps it was indicated for child #7 who had convulsions, but why a medical professional would risk inflicting it on a patient to diagnose or treat a bowel disorder is beyond me.

By squirrelelite (not verified) on 08 Mar 2012 #permalink

The retraction of the interpretation came out before it was discovered that Wakefield made up the data within the paper. You cannot therefore credibly claim that it means the data is instead correct.

patricia, do you realize that the only actual issue in the ruling was whether Walker-Smith considered what he was doing research? How exactly does that stretch to the extents you're claiming? I want a specific chain of reasoning that leads from "Walker-Smith didn't think he was doing research" to "That finding is enough simply to discredit the GMC Tribunal altogether. It cannot stand."

Oh Todd I see where you are coming from!
The Judge didn'tsay that the Professor was innocent of all charges! Just that those charges were unfounded and mistaken and lacking in evidence and reasoning and that therefore...

Umm sorry Todd, don't get it.....

"The retraction of the interpretation came out before it was discovered that Wakefield made up the data within the paper. You cannot therefore credibly claim that it means the data is instead correct."

Where does The Highest Court in the UK ,London High Court Judge Mitting dispute the paper and its data?

Now why is it, that the highest court in the UK did not discover that??answers on the back of the postage stamp please...to Brian Deer ,he told you all so that, the data was flawed...

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

@patricia

I don't know how to simplify it further for you, patricia. Do go back to the original documents and read them. Try thinking things through for yourself after doing so, rather than going with what the authors at AoA/JABS/SafeMinds/etc. tell you.

Oh, and as to the spittle comment, I made that because your post had a tone of inchoate rage.

Cynical Pediatrician

Wrong The paper does not link Autism just bowl disease..try again you have all been lied and lied to by Deer

See my comment 28

"Simply and firstly Dr Wakefieldâs paper never claimed a link between autism and MMRâ¦What it DOES report is a link between bowel disease and ASD. That finding still stands and is now endorsed by paediatric gastroenterologists worldwide. JWS and his team were the first to investigate and report on this. The GMC decision - which is now DISCREDITED - did untold damage to the continuing work on this issueâ¦it simply follows that Deer,Godlee and perpetrators of the lies and fanning the lies should be held to book, and kicked up the arse so hard they never sit down againâ¦happy days guysâ¦happy days a discredited GMC once again.."

..Sucker for wanting to believe it in the first place...

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

The fact that Wankerfield was paid to commit gross fraud and manufacture data is entirely independent of Mitting's ruling. Or the entire GMC process, for that matter.

Beamup

"
The fact that Wankerfield was paid to commit gross fraud and manufacture data is entirely independent of Mitting's ruling. Or the entire GMC process, for that matter.

now who told you that one..eh!! Deer by chance??one of the Murdoch viper`s

http://themurdochempireanditsnestofvipers.blogspot.com/

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

@OQF - so Wakefield wasn't paid by a Solicitor filing suit related to vaccine injuries?

I can't help but suspect that, if you had some actual EVIDENCE to contradict Deer's findings, you'd present it. But you are apparently unable to do so. Nor is Wankerfield.

Lawrence great tact if you could get OFFIT but the point of fact is simply the data stands and it is reasonable to reinstate the staus quo prior to the GMC decision..you need pharma free time to think for yourself rather than asking Messiah Deer for advice,time is on our side...

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

The status quo before the GMC decision was that Wankerfield was a liar, a fraud, and a killer of children. So yeah, pretty much unchanged there.

Patricia:

I said that this view emphasised my belief that the case as such, should never have been presented in the first place. It was an unprofessional and wholly inadequate case presented by a bunch of amateurs with insufficient legal expertise. Oh, and since the whole case had been perpetrated in the first instance solely by Brian Deer and his cohorts, it therefore challenged their credibility in pursueing their twisted and wrongful interpretation of events. My words not Judge Mitten's.

Who are Mr. Deer's cohorts?

Have I missed out stuff?

Why, yes. Did you even read the articles I posted at LB/RB by Dr. Elliman, Dr. Taylor and Dr. Goldacre? Go back and look for the links (they are printed in red on that blog), and read them. Look at the dates and tell us if they come before or after Mr. Deer's articles.

In summary, Patricia and OQF, Wakefield's "research" was deemed wrong and insignificant before Mr. Deer came to the party. That little paper should have faded into the shadows, but it did not due to idiot journalists. While all the time you and friends became fanboys and fangirls of a psychopath (who are often very charming on the outside).

Beamup

Comment 34 ..

The High Court said the decision was âflawed, in two respects: inadequate and superficial reasoning and, in a number of instances, a wrong conclusionâ.

Ruling, Mr Justice Mitting stated: âThe panel had no alternative but to decide whether Professor Walker-Smith had told the truth to it and to his colleagues, contemporaneously. The GMCâs approach to the fundamental issues in the case led it to believe that that was not necessary â an error from which many of the subsequent weaknesses in the panelâs determination flowed.

âIt had to decide what Professor Walker-Smith thought he was doing: if he believed he was undertaking research in the guise of clinical investigation and treatment, he deserved the finding that he had been guilty of serious professional misconduct and the sanction of erasure; if not, he did not, unless, perhaps, his actions fell outside the spectrum of that which would have been considered reasonable medical practice by an academic clinician.

âIts failure to address and decide that question is an error which goes to the root of its determination.â

You lot have a brain cell between ya! yeah!!na!thought so just keep taking the pharma dollars trolls

If you draw this to its natural conclusion (collusion by Deer and Godlee) it would be reasonable to expect the same yard stick has been applied to Deerâs lies. which will no doubt unfold in the coming yearâ¦Evidence well Deer denying bowl disease when mothers hold up pictures of kids aged 15 weighing 5 stonesâ¦now is that denial or what. but thatâs of the subject matter..Mitting has delivered one massive blow to you Pharma whores and you deserve it. royally so..

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

The retraction of the interpretation is often misquoted as being most of the authors disowning the paper (as posts above) . The data within the paper holds true. Wake up call for you Pharma whores.

The data within the paper does not hold true: Wakefield demonstrably misrepresented or otherwise altered the medical histories of all 12 subjects.

@OQF - I notice you didn't answer the question.

@ squirrelelite: Your headache following your first L.P. is more commonly reported in medical journals.

There is no medical justification for performing L.P.s on a child who has a seizure disorder absent meningeal signs (meningismus)...except in the case of an infant who presents with a FUO (fever of unknown origin); infants do not show the classic meningeal signs. Other children who present with FUO and who have severe cerebral palsy may require a L.P. because classic meningeal signs are "absent" as well.

Why did the parents of the children in the Wakefield study consent to these multiple painful invasive procedures?

Why do these same parents continue to support Wakefield...since the GMC ruled that he committed egregious "serious medical malpractice" on their children?

@OQF-
One of Wakefield's key claims was that measles virus caused lymphoid hyperplasia in the gut which led to developmental disorders, such as autism; he also claimed that this sequence correlated with administration of the measles mumps rubella vaccine.

To quote from Wakefield's own abstract:
"Onset of behavioural symptoms was associated, by the parents, with measles, mumps, and rubella vaccination in eight of the 12 children."
"Behavioural disorders included autism (nine)[out of 12]"
"We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers."

Are you suggesting that the words "autism" and "measles" in the abstract were typographical errors? That they do not mean what we think they mean? That the inclusion of information regarding administration of the MMR vaccine was an purely incidental and irrelevant detail?
Have you even read the abstract or paper?
In any case, whatever you might think his paper says, his claims have been disproven by other researchers.

It's one thing to claim an interesting hypothesis. It's another to keep beating a dead horse.

By Cynical Pediatrician (not verified) on 08 Mar 2012 #permalink

Who are Mr. Deer's cohorts?
If they are not gleaming in purple and gold then they are not real cohorts.

By herr doktor bimler (not verified) on 08 Mar 2012 #permalink

@Once Queer Fish:

Lawrence great tact if you could get OFFIT but the point of fact is simply the data stands and it is reasonable to reinstate the staus quo prior to the GMC decision..

Repeating myself:

The Lancet's editors on the retraction:

... it has become clear that several elements of the 1998 paper by Wakefield et al1 are incorrect, contrary to the findings of an earlier investigation. In particular, the claims in the original paper that children were "consecutively referred" and that investigations were "approved" by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record.

Neither of those two things (consecutive referrals or ethics committee approval) were contradicted by the judgement, so The Lancet has no reason to undo the retraction.

By Matthew Cline (not verified) on 08 Mar 2012 #permalink

As indeed Judge Mitten has emphasised in his quashing of their verdict.
My words not Judge Mitten's.

I am left to speculate whether Patricia is on such familiar terms with Mr Justice Mitting that she has her own pet name for him, and her own pet title.

By herr doktor bimler (not verified) on 08 Mar 2012 #permalink

If you draw this to its natural conclusion (collusion by Deer and Godlee) it would be reasonable to expect the same yard stick has been applied to Deerâs lies.

Let's cut to the chase: what statements has Brian Deer published regarding Wakefield himself or his retracted Lancet paper that constitute lies?

Be as specific as possible--in fact, provide direct quotes with attribution.

As I have notice John Stone has just posted ...says most of the Pharm Whore questions...that have been plied to me..if not let me know...kind regards OQF

High Court findings on Prof John Walker-Smith regarding the Wakefield "Lancet" paper
8 March 2012
I note from BMJ's statement regarding the Wakefield libel suit reported in the Guardian in January [1]:

"Despite the findings of the GMC's Fitness to Practice Panel and his co-authors having publicly retracted the causation interpretation put forward by the Lancet Paper, it would appear from the Claim filed at court that Mr Wakefield still stands by the accuracy of the Lancet paper and his conclusion therein, thereby compounding his previously found misconduct."

In view of the fact that Sir John Mitting in the High Court has now entirely overturned the findings of the GMC regarding the Lancet paper, BMJ may like to consider whether they have not built on sand [2].

[1] Ian Sample, 'Andrew Wakefield sues BMJ for claiming MMR study was fraudulent' Guardian 5 January http://www.guardian.co.uk/society/2012/jan/05/andrew-wakefield-sues-bmj…

[2] Prof John Walker-Smith vs GMC before Mr Justice Mitting, judgement 7 March 2012 http://www.bailii.org/ew/cases/EWHC/Admin/2012/503.rtf

Competing interests: Son was a patient of Prof Walker-Smith

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

"...Sir John Mitting in the High Court has now entirely overturned the findings of the GMC regarding the Lancet paper..."

You realize that this is an entirely false statement, right? Did you even bother to read the decision?

Careful with the hyperbole. Leave that to the anti-vaxers.

I don't consider it hyperbole. The death of children from measles was a predictable outcome of his actions (if one presumes he'd be listened to). And it has indeed come to pass, when it likely would not have sans Wakefield.

You all just argue amongst yourselves ...obviously now implodding..Cheers to Brian

HA HA HA HA HA HA!!!

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

@93

I was thinking the same thing:

In view of the fact that Sir John Mitting in the High Court has now entirely overturned the findings of the GMC regarding the Lancet paper, BMJ may like to consider whether they have not built on sand

The Lancet paper was not on trial, nor the results contained within. The ruling is about Prof John Walker-Smith, whether he was doing research or treating children. In the first case the GMC ruling stands, in the second case he felt the GMC ruling should be overturned.

Nothing about the actually validity of the Lancet paper.

By stewartt1982 (not verified) on 08 Mar 2012 #permalink

@OQF - still not answering the question, are you?

Todd

I am quite surprised by your delusional images of me in an "inchoate rage". Wow. I don't do rage on these forums. I laugh a lot. And sometimes I feel close to weeping. With depression. So much angst here and venom.

Patricia, did you read the articles by Dr. Elliman, Dr. Taylor and Dr. Goldacre that I linked to on LB/RB? What were the dates and what did they say? Do they support Wakefeild's hypotheses?

@95 - OQF

You have an interesting view of the world ... as if disagreement is a terrible thing. Do you agree with every statement and tactic used by anti-vax proponents? I'm guessing you must or you'd be a hypocrite.

By stewartt1982 (not verified) on 08 Mar 2012 #permalink

@Beamup

I agree that measles deaths due to the fear of MMR that came about as a result of Wakefield's shameless self-promotion can be laid squarely at his feet and at the feet of the media that eagerly lapped up his drivel. However, be careful with wording lest someone accuse you of saying that he directly killed kids with his own hands.

I left a comment here comparing the charges where Mr. Wakefield was found guilty of "serious professional misconduct" and Prof. Walker-Smith was found guilty of the same (pre appeal)

It's stuck in spam-trap land, but it is also here:
http://leftbrainrightbrain.co.uk/2012/03/walker-smith-wins-appeal/#comm…

Note that there is little overlap. Should one say that the appeal negates any areas where there the charges against Mr. Wakefield and Prof. Walker-Smith overlap, one is left with a number of charges against Mr. Wakefield which still would stand.

@ Todd W:

OK, I can buy that. Would you be happier with "indirectly brought about the death of children from measles?"

OQF, answer Lawrence's question. Or let me restate that: what was the financial relationship between Richard Barr and Andrew Wakefield? Should it have been listed as a conflict of interest on the still retracted Lancet paper?

(Beamup and Todd, I have also learned by reading MMR vaccineâworries are not justified that children were also given less effective and possibly more dangerous single mumps vaccines due to Wakefield's evidence-free suggestion at his press conference. It is interesting the things you learn while searching PubMed.)

@patricia

Apologies if I misread the tone of your comment at #40, though quite interesting that you would suggest that I am delusional, rather than simply mistaken.

And again, sorry that I was unable to boil Justice Mitting's ruling down simply enough for you to understand. I just really don't know how to make it any more plain.

You Pharma whores all contently digress into other matters when the subject matter is has kudos...suc as my comment

Comment 34 ..
The High Court said the decision was âflawed, in two respects: inadequate and superficial reasoning and, in a number of instances, a wrong conclusionâ.
Ruling, Mr Justice Mitting stated: âThe panel had no alternative but to decide whether Professor Walker-Smith had told the truth to it and to his colleagues, contemporaneously. The GMCâs approach to the fundamental issues in the case led it to believe that that was not necessary â an error from which many of the subsequent weaknesses in the panelâs determination flowed.
âIt had to decide what Professor Walker-Smith thought he was doing: if he believed he was undertaking research in the guise of clinical investigation and treatment, he deserved the finding that he had been guilty of serious professional misconduct and the sanction of erasure; if not, he did not, unless, perhaps, his actions fell outside the spectrum of that which would have been considered reasonable medical practice by an academic clinician.
âIts failure to address and decide that question is an error which goes to the root of its determination.â

Just how is Deer Brian going to de-frock this it come form the Highest Court in the Uk from the highest Judge in the UK so does Deer Brian know betterâ¦Hear The Silence???

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

OQF:

You have manifestly failed to provide a clear line of evidence & logic showing that the success of Walker-Smith's appeal and the ruling provided follow to any kind of vindication of Andrew Wakefield. All you have done is spammed this comment thread with inchoerent rants and quote-mines of the ruling.

As such, there is no reason to seriously address your claims or comments.

@Composer99: I've had OQF killfiled for ages, and was quite surprised to see him crawl out of the ooze for this post; he hasn't been around for a while.

@Chris: I doubt patricia will read your links. She doesn't want to read anything that proves St Andy used fraudulent data, and any research that disagrees with him was done by Big Pharma, anyway. Her insult to lilady nearly led me to killfile her but I wanted to see how far she'd go.

Com---POSER 99

Keep taking the pharma meds and dollars they do well for ya!
wouldnât want you out in mainstream life .Stay in your one bed , bed sit posting ,it workâs for ya...as all the main bloggers on here are..

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

MI Dawn ..

Never heard of ya! despite your self apported slayer..

mind you Deer never heard of Mitting better watch out...

Great how the subject digress when the trolls cant argue the points ..la!la! fingers in mee ears but i can still read

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

@108 - OQF:

Somehow you manage to both get it, yet profoundly not understand. It boggles the mind.

You quote from 34 from the appeal decision:

"It had to decide what Professor Walker-Smith thought he was doing: if he believed he was undertaking research in the guise of clinical investigation and treatment, he deserved the finding that he had been guilty of serious professional misconduct and the sanction of erasure; if not, he did not, unless, perhaps, his actions fell outside the spectrum of that which would have been considered reasonable medical practice by an academic clinician.

This is exactly what I and others have said in previous posts. The court had to decide on whether Prof. Walker-Smith was doing research or believed himself to be be acting simply acting as a medical doctor and providing treatment.
One can agree with the judges interpretation of Prof. Walker-Smith or not.

What it does NOT say, is that the research in the Lancet paper was correct, nor that Wakefield didn't manipulate data, nor that Brian Deer's article in the BMJ is incorrect.

I'm starting to think that you might not understand the word silence. Perhaps you think it means "not hearing agreeing opinions"?

By stewartt1982 (not verified) on 08 Mar 2012 #permalink

It also does NOT say that Wakefield did not do research unfaithfully ... he still didn't get ethical committee approval and had undisclosed COIs.

By stewartt1982 (not verified) on 08 Mar 2012 #permalink

Patricia's fangirl effusions about Wakefield are really skeeving me out. "He's so nice! So good looking! So erudite! A real man! If you don't admire him like I do it's because you're just jealous!"

It is best to just ignore the OQF Troll...he's proven himself to be an ignorant, devoid of argument Wakefield fanboi.

@ Mi Dawn: Please don't killfile dear Patricia...I'm having some perverse fun with her.

Patricia dear, why don't you provide the medical justifications for Wakefield ordering painful, invasive tests on his study participants?

And so the very High Court In London never picked up on any of these points ..bunch of pharma whore jokers that you all are digress to anything but the matter...Deer has mis-lead you all...take the dollars and run!!run!!!John Wayne is Big Leggy...

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

no pharma big hitters want a hit?

bring it on??

Deer about ..not a chance...run run run..but you all cant hide..

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

So OQF keeps on rolling along.

I remember the last time OQF tried to hijack a thread, yet I cannot determine the motivations behind the troll's inane postings. Is it his undying (and unwarranted) devotion to the disgraced doctor or, his immense jealousy of Brian Deer's superb investigative journalism skills?

Ugh, the anti-vaxers didn't waste any time in claiming that this exonerates Wakefield, did they? If it does, then why didn't the good judge just go ahead and clear Wakefield also? I mean, if it's the just thing to do, then why not go ahead and do it regardless of a Wakefield appeal or not? If a convict is found to be innocent in the course of the appeal of another person, does the convict have to appeal for justice to be done?

I'm thinking not.

Let me further discuss the so-called *posh* theory**:

I don't think AJW can feasibly claim poverty as the reason he didn't pursue an appeal and/ or sue his detractors in the UK.
He is not impoverished. I can quote Todd W. @ RI ( who looked it up): his house in Austin is worth, IIRC, 900K. USD.
He comes from a family of physicians, is married to a doctor, had worked for many years ( he's over 50), has friends and supporters and probably has investments- like most professional people do.
Most tellingly, he is able to raise funds now- which he is doing for his American lawsuit.
So in my book, he's posh- better off than most. He wears expensive clothes ( see photo AoA). And as to jealousy: 'fraid not. I'm (at least) semi-posh myself: I live as I choose, do meaningful work and have never been in trouble of any sort- but I could certainly raise funds if I were in his predicament- needing to appeal an unjust judgment; even if I *were* broke my cohorts and cousins would come to my aid. Plus, I'm better looking than he is. Seriously.
Lighten up, Patricia, we aren't your enemies.

** that has got to be a gift from the heavens to me. And I thank my lucky stars for it.

By Denice Walter (not verified) on 08 Mar 2012 #permalink

Agree with the premise that the exoneration of W-S does not equate to the exoneration of Wakefield.

What it does do is demonstrate that in the view of Mitting, the GMC got it wrong for W-S, that W-S should not have been struck off and accordingly that finding by GMC is quashed.

Worrisome for some, delightful for others, is that the Mitting ruling demonstrates as well that the GMC is fallible.

Now I can recall reading ad nauseum statements by Mssr Deer that Wakefield is guilty to the "highest evidentiary standard." Well, now, maybe not. Not exonerated, to be sure, but found guilty by a panel that publicly and spectacularly screwed the pooch in a similar related case.

To those who disagree with Mittig- get over it, or file an appeal. Quit whining and quibbling, it is most unseemly. Don't allow yourself to resemble a bunch of
AoAers petulantly stamping your feet because you disagree with a procedural ruling.

By Proscientifica (not verified) on 08 Mar 2012 #permalink

@lilady: never fear. If I killfile patricia, you will still see her. And even better, I'll get to read your intelligent responses without having to read her inane blather first.

@DT35: Yeah, patricia's Waker worship is rather creepy, I think... she sounds like a teenager drooling over the Beatles.

@ Ren: It is similarly analogous to a criminal trial, where a man indicted for an armed robbery is able to *prove* that he was unaware that the guy he accompanied into a liquor store was actually going to rob the owner. Said "innocent" bystander claims he had no knowledge that gun in the glove compartment that the robber put into his pocket, and the ski mask that his friend donned upon entering the liquor store, were going to be used in an armed robbery.

Meanwhile, the actual gun-toting robber sits in jail after having been found guilty. The evidence against him (video surveillance, his fingerprints and his DNA on the gun), is overwhelming.

Why would the convicted armed robber and his supporters think that his friend's beating of the rap, exonerate him?

@lilady

Why would the convicted armed robber and his supporters think that his friend's beating of the rap, exonerate him?

Because they're against any and all forms of vaccination due to a misguided, misinformed world view where "everyone is on the take" (to paraphrase Jake) and "western medicine", chock-full of evidence, is sorcery while "natural medicine", chock-full of magic, is the Truthâ¢. That's why.

(What's the over/under on how much time until someone at AoA posts a comment stating that we're calling Wakefield an armed robber?)

Given how willing the Wakefield apologists are to completely make up stuff not contained in, or even implied by, this ruling, I wonder why they bothered to wait for this before saying all of the nonsense offered above. They could have just as easily, and logically, picked up a 2010 copy of Cat Fancy and said "How do you explain THIS, Brian Deer? It PROVES that all of the Pharma Whores were conspiring to slander Wakefield!"

Yes it does, Queer Fish. The eyes of that marmalade on page 42 are especially damning.

By ConspicuousCarl (not verified) on 08 Mar 2012 #permalink

@ Ren: If only...AJW's "crime" was an armed robbery and, if only...AJW didn't *double-down* on the bullshit of *all vaccines-causing-autism pseudoscience*, I wouldn't be so harsh on him.

The man is a public health menace; responsible for the deaths of children from vaccine preventable diseases.

Comment 34 ..
The High Court said the decision was âflawed, in two respects: inadequate and superficial reasoning and, in a number of instances, a wrong conclusionâ.
Ruling, Mr Justice Mitting stated: âThe panel had no alternative but to decide whether Professor Walker-Smith had told the truth to it and to his colleagues, contemporaneously. The GMCâs approach to the fundamental issues in the case led it to believe that that was not necessary â an error from which many of the subsequent weaknesses in the panelâs determination flowed.
âIt had to decide what Professor Walker-Smith thought he was doing: if he believed he was undertaking research in the guise of clinical investigation and treatment, he deserved the finding that he had been guilty of serious professional misconduct and the sanction of erasure; if not, he did not, unless, perhaps, his actions fell outside the spectrum of that which would have been considered reasonable medical practice by an academic clinician.
âIts failure to address and decide that question is an error which goes to the root of its determination.â

Just how is Deer Brian going to de-frock this it come form the Highest Court in the Uk from the highest Judge in the UK so does Deer Brian know betterâ¦Hear The Silence???

Where do I refer to Dr Wakefield or Mr Wakefield so as you know Mr in surgical terms is a higher title than Dr ,Royal College of Surgeons of Edinburgh (chartered 1505),

http://en.wikipedia.org/wiki/Fellowship_of_the_Royal_College_of_Surgeons

..going back to 1505 when America was still running around with fuck knows what John Wayne would tell ..ya!! John Wayne is big Leggey get wise pharma whores..

By One Queer Fish (not verified) on 08 Mar 2012 #permalink

I see John Stone's queer parrot fish is back. yawwwwn..

126 Autismum

Andrew Wakefield does have a lovely, posh voice. It makes all his lies sound so nice.

The fish agrees. According to queer parrot fish..

#246 OQF ["As Andrew Wakefield's defenders circle the wagons" thread -Jan 2011]

Simply. anyone who met AW would rapidly form the impression within a half-hour, if not just minutes, that he is a good person, who really had the children's interests at heart and had has nothing to hide.

Very surprised to see only one instance of each of its posts here. On the thread above it decided that repetitively spamming the same comment gave its regurgitations some credibility. Shame I can't stay and play today.

By Sauceress (not verified) on 08 Mar 2012 #permalink

Autismum:

Andrew Wakefield does have a lovely, posh voice. It makes all his lies sound so nice.

Personally I find his voice smarmy and, frankly, he is very creepy.

Proscientifica:

Now I can recall reading ad nauseum statements by Mssr Deer that Wakefield is guilty to the "highest evidentiary standard." Well, now, maybe not. Not exonerated, to be sure, but found guilty by a panel that publicly and spectacularly screwed the pooch in a similar related case.

Guilty or not, Wakefield is still wrong. Several studies and several reviews of his work showed he was wrong before and after Deer came on to the scene. Here are some papers for your perusal:

Arch Dis Child. 2001 Oct;85(4):271-4.
MMR vaccine--worries are not justified.

Lancet. 1999 Jun 12;353(9169):2026-9.
Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association.

BMJ. 2002 Feb 16;324(7334):393-6.
Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study.

Mol Psychiatry. 2002;7 Suppl 2:S7-8.
Autism and MMR vaccination in North London; no causal relationship.

And an award winning article by Dr. Ben Goldacre: MMR - Never Mind the Facts. Now what do you notice about the dates of all of those articles?

Just how is Deer Brian going to de-frock this it come form the Highest Court in the Uk from the highest Judge in the UK so does Deer Brian know betterâ¦Hear The Silence???< ?i>

The Right Honourable the Lord Phillips of Worth Matravers, KG, President of The Supreme Court of the United Kingdom -- previously Lord Chief Justice of England and Wales -- will be very sad to learn of his demotion.

By herr doktor bimler (not verified) on 08 Mar 2012 #permalink

No disagreement that the researcher Wakefield may have his facts wrong, that the syndrome he postulated in Lancet may not exist.

No disagreement that he is not exonerated.

Peer review is the process by which science advances. I for one am grateful that Lancet accepted the paper for publication. The paper was offered to be refuted or replicated, thus far is has not apparently been replicated and it may in fact be refuted along with retracted.

So Wakefield exposed his hypothesis to the rigors of scientific examination and the process has unfolded. Along the way, he,like W-S, was found guilty of nefarious activities "to the highest evidentiary standard."

Mittings case by case review of each Lancet child's journey is meticulous. Reminds me of the story of the seven blind men and the elephant. This episode has become a Rorschach test for one's view on vaccine safety. People see in it what they want to see, or are pre-disposed to believe. Science, I fear, has been left in the emotional dust.

By Proscientifica (not verified) on 08 Mar 2012 #permalink

Just how is Deer Brian going to de-frock this it come form the Highest Court in the Uk from the highest Judge in the UK so does Deer Brian know betterâ¦Hear The Silence???

The Right Honourable the Lord Phillips of Worth Matravers, KG, President of The Supreme Court of the United Kingdom -- previously the Lord Chief Justice of England and Wales -- will be desolated to learn of his demotion.

By herr doktor bimler (not verified) on 08 Mar 2012 #permalink

Proscientifica:

You do realize that Wakefield really did commit fraud, right? And that he really did engage in public statements, based on his 1998 Lancet paper which were not supported by the paper, right?

As such, he can hardly be said to have legitimately exposed a hypothesis of value to the rigours of scientific examination?

What I've gleaned from AJW ( from photos, audio and video):
he seems a master of image management- carefully presenting himself as a sincere, caring person. The desired impression is meticulously honed: the right gestures, expression and clothing accompany his sounding *concerned*. It's studied and rehearsed like an actor playing the role of an especially dedicated doctor: someone you want on your side. Oh where have I seen this act before?

Our woo-meisters also put on the airs of humane, altruistic interest to accent their cargo cult hoarde of faux science. They're there to help you because you're important. Costume and vocal qualities are fine tuned to create a quiet dignity and an aura of deep reverent thought. Salemen ( women) work on appearing trustworthy and knowledgable but woo-meisters take it to the next level: spirituality! Their motives are sacrosanct and the patient's welfare is their utmost concern.

It's stagecraft and skilled performance- developed over years: how can regular folk compete with this? I grew up around business people- perhaps I'm somewhat immune. These manipulations are easy to learn and easy to spot: look and listen carefully the next time you watch you-tube woo. Faux sincerity drips like honey.

By Denice Walter (not verified) on 08 Mar 2012 #permalink

Lilady

The man is a public health menace; responsible for the deaths of children from vaccine preventable diseases.

Evidence? Citations?
You make a claim? You back it up with evidence not libel. You're supposed to be a critical thinker. You're not.

Name one child, please, whose death was caused by Andrew Wakefield and how you came to this evidence.

Otherwise, sit back down and stop slamming your hands into the keyboard.

By augustine (not verified) on 08 Mar 2012 #permalink

@Denice Walters:

Could you poison the well a little more with your fallacies?

What I've gleaned from AJW ( from photos, audio and video):
he seems a master of image management- carefully presenting himself as a sincere, caring person.

And exactly how do you know he's not a sincere caring person? A hunch? An intuition? From looking at photographs?Is this what they taught you in your psychiatric classes or is this a special gift you acquired from childhood?

these manipulations are easy to learn and easy to spot: look and listen carefully the next time you watch you-tube woo.

Thanks for your fact free opinion! Good grief!

By augustine (not verified) on 08 Mar 2012 #permalink

Lildady:

@ Mi Dawn: Please don't killfile dear Patricia...I'm having some perverse fun with her.

Lilady, what you are experiencing is called Delusions of Grandeur. You have a skewed sense of self. I believe you overestimate your powers.

By augustine (not verified) on 08 Mar 2012 #permalink

Just what I was thinking, Herr Doktor! Of course, since OQF approves of his ruling, it naturally follows that Mr. Justice Mitting should be Lord Chief Justice, even if reality has not quite caught up yet.

Though I note that this opinion is not quite universal. Googling around the internet to find Mitting opinions in other cases (his area of expertise is immigration matters), the first article that popped up described him as a "hapless buffoon." How regrettable that writer lacks OQF's incisive insight!

his area of expertise is immigration matters
I believe this has sometimes led him to order the release of scary brown people, in accordance with the actual law rather than with the desire of the authorities to hold those scary people in custody. It is therefore quite plausible that the British gutter press will describe him as a "hapless buffoon."

Mitting is not the paramount judge within the High Courts (Queens Bench division) -- that honour being reserved for the current Lord Chief Justice, Justice Igor Judge (privy councellor and Baron Judge) -- Lord Justice Judge Baron Judge for short. I am not making this up.

By herr doktor bimler (not verified) on 08 Mar 2012 #permalink

The reason Wakefield did not appeal is quite simple. Following his GMC case, his attorney, Kieran Coonan, was consulted by the Medical Protection Society, which funded the case. His advice was that Mr Wakefield would be unlikely to win on appeal. The case against him was very different.

My impression is that many observers of the case came to believe that it was about "ethics" of invasive research. This was what the British lawmaker Evan Harris took up. This was a huge distraction. If you look at Deer's investigation, he hardly ever mentioned the ethics of it. The case against Wakefield was over the integrity of the findings.

That was where the damage was done to Wakefield. I believe Wakefield will be devastated by the Mitting judgment, which comes to his aid in no way at all.

Many English judges loath the GMC and routinely abuse it in their judgments. Although, if you read Mitting's judgment in isolation, you might think he was critical. Actually, his general criticisms of process are very muted, and remain focused on Walker-Smith.

Apart from "consecutive", where Mitting has one view and the panel of five had another view, there is nothing for Wakefield to get his teeth into.

He ain't coming back, that's for sure.

Whoah. somebody stop the barge.
The Wakefield fans have forgotten that Denial isn't just a river in Egypt.

@ augustine:

I have no idea whether AJW is a caring, sincere person or not- that's not the issue: I am merely stating that he projects an assiduously maintained good front. I have a negative opinion of him because the evidence suggests that he manipulated data and the subject selection process, used un-warranted invasive tests on children, didn't reveal his conflicting business concerns, wasted public funds et al.

-btw- You obviously haven't been around the business world, have you? Many people make a decent living by training others how to speak, dress and act appropriately for careers. Candidates may track their progress by video prior to interviewing. Psychologists study impression formation also. Watch people who work on television news- you'll notice they look and sound a certain way: it's no accident, they've worked very hard on it.

You should really get out more: it's a wide world and has all sorts of interesting people in it. Things aren't always what they appear to be on the surface.

By Denice Walter (not verified) on 09 Mar 2012 #permalink

OQF: not quite sure if dumb as a post or drunk... please clarify.

By stuv.myopenid.com (not verified) on 09 Mar 2012 #permalink

Question: did any of the Lancet kids have bowel disease? I read a post here yesterday that suggested that the children did not have bowel disease, this from Mittig's decision:

"On 15th October 1996, Dr. Pegg wrote to Professor Walker-Smith telling him that Project 172-96 would be discussed at the next meeting of the Ethics Committee. He set out his reservations and invited comments. He categorised some of the investigations as âhigh riskâ, in the categorisation adopted by the British Paediatric Association in guidance published in August 1992, which advised that it would be unethical to submit child subjects to more than minimal risk when the procedure offers no or a slight or very uncertain benefit to them. Accordingly, he sought confirmation âthat the child would undergo this regimen even if it was not in a trialâ. He also raised a query about the consent form which parents would be required to sign before the investigations required by the study were performed on their child. This elicited a reply from Professor Walker-Smith dated 11th November 1996, the relevant part of which states:

ââ¦Clearly this is an intensive regime with procedures that could be regarded as âhighâ risk although they are particularly used for the investigation of children with chronic inflammatory bowel disease. These children suffer from a disease with a âhopeless prognosisâ in relation to their cerebral disintegrative disorder. They have often not had the level of investigation which we would regard as adequate for a child presenting with such a devastating condition. In relation to their gastrointestinal symptoms which will be present in all the children we investigate, these have often been under-investigated. We have so far investigated five such children on a clinical need basis, all in fact have proved to have evidence of chronic bowel inflammation. One child has already had a significant response to enteral feeding. Certainly there is a measurable benefit to the child:
i) establishing a diagnosis and excluding metabolic and other causes.
ii) commencing on a therapeutic regime.
This whole study is parent/patient driven as every case referred has been initiated by the GP by the parents of the child.
I can confirm that children would have these investigations even if there were no trial. I must make clear that we would not be investigating children without gastrointestinal symptoms.â

By Proscientifica (not verified) on 09 Mar 2012 #permalink

From the hearing:

"Despite the justified reservations of Professor Walker-Smith and Dr. Murch about Dr. Wakefieldâs hypothesis, they were both convinced that the investigations into the twelve âLancet childrenâ had been of diagnostic value for all of them and therapeutic value for most of them. On 14th October 1997, Professor Walker-Smith wrote to Dr. Salisbury, following a meeting at the Department of Health:

âOn the issue of autism, I am completely astounded by the clinical features of these children with autism and bowel inflammation. Very often the gastrointestinal symptoms have been ignored by a succession of the doctors and the findings on ileo-colonoscopy appear to be quite distinctive. This seems to me a whole new syndrome which is in urgent need of clarificationâ.

By Proscientifica (not verified) on 09 Mar 2012 #permalink

From hearing, quote by W-S-

"In relation to your last comments, I am certainly doing nothing to pressure the family to see us. In fact my department is somewhat overwhelmed by the response of parents who believe that their children have autistic and gastrointestinal symptoms following MMR. I personally had no idea that there were such large numbers of patients in the community across the country where the parents had made this associationâ¦â

This comment made before Lancet 1998 published.

By proscientifica (not verified) on 09 Mar 2012 #permalink

Don't underestimate him, stu--I've known people to manage both simultaneously.

@One Queer Fish:

Where does The Highest Court in the UK ,London High Court Judge Mitting dispute the paper and its data?

And so the very High Court In London never picked up on any of these points ..

So, are you saying the Judge Mitting threw out every single little thing the GMC found, and Mitting basically did the whole thing over again, so if Mitting didn't re-affirm a finding of the GMC that finding is out the window? For example, the GMC found that the referrals to Wakefield were non-consecutive, but since Mitting didn't mention anything about the referrals, the GMC's finding about non-consecutive referrals is out the window?

By Matthew Cline (not verified) on 09 Mar 2012 #permalink

Proscientifica #149,

This comment made before Lancet 1998 published.

It was indeed, in response to a letter from Child J's pediatrician to W-S asking him and his department to stop putting pressure on Child J's family to ask him to refer Child J to W-S. When asked why he wrote in such stern terms this doctor explained:

Because the Royal Free team contacted me persistently regarding this young man. I could appreciate the family may have contacted them, but I, too, had spoken to the family about it and expressed my view. I might have expected the team to have taken my view and given some respect to my view, rather than persistently contacting me and recommending that I should make a referral to them.

One wonders how it was that a GP should be irritated enough to write to W-S asking him to cease and desist pestering the family, yet W-S is apparently unaware of any such pestering. It's almost as if a member of W-S's team was actively recruiting these children without W-S's knowledge. This would explain why W-S is surprised at all these referrals appearing seemingly from nowhere. As the GP wrote:

I understand that Dr Wakefield has been continuing to send the family information. In particular he has been sending them information from a firm of solicitors who seem to specialise in litigation in relation to immunisation.

It certainly looks to me as if Wakefield was casting his net far and wide looking for children with autism and gastrointestinal problems that had started after MMR for this study, mentioning litigation that offered possible financial reward. Not surprisingly he found quite a number. This does not reflect well on either Wakefield or W-S. All quotes from GMC transcripts.

By Krebiozen (not verified) on 09 Mar 2012 #permalink

Oops. I meant "as the pediatrician wrote", not the GP.

By Krebiozen (not verified) on 09 Mar 2012 #permalink

Proscientifica,

Question: did any of the Lancet kids have bowel disease?

Not inflammatory bowel disease by most gastroenterologists' standards. Most of the biopsy findings, blood inflammatory markers, barium meals and endoscopy results were essentially normal, and were reported as such, except for Child 9, as I recall. The retracted Lancet paper was supposed to identify a new clinical entity, a collection of inflammatory changes in the bowel, W-S's "whole new syndrome", that were previously considered normal. Whether that syndrome actually exists or if it was merely an artefact of some sort is still not really clear.

As we have seen, Wakefield had put out the word that he was looking for autistic children with bowel disorders, so you would expect him to have found just that. What surprises me is that most of the biopsies were reported as normal by the routine histopathologists. Autism exists and bowel disorders exist, so there will necessarily be some individuals with both purely by coincidence, but none of the Lancet 12 seem to have had unequivocal inflammatory bowel disease.

The important question is whether bowel disorders are more common in autistic individuals than in non-autistic individuals and if there is any relationship between them, for example a common cause. That question is not answered by the Lancet study, and other evidence I have seen is contradictory. Some studies have found an increased incidence of inflammatory bowel disorders in autistic individuals, and some have not. More research is needed to establish if there is a link between bowel disorders and autism and if there is, what its significance might be.

Unfortunately the purported link between autism and bowel disease has become connected with Wakefield's discredited study in many people's minds, which I suspect may have made research in this area less attractive. It may be that an important discovery has been delayed because of this.

By Krebiozen (not verified) on 09 Mar 2012 #permalink

@Denice,

I have no idea whether AJW is a caring, sincere person or not- that's not the issue: I am merely stating that he projects an assiduously maintained good front.

Assidious? Would you charactize drug companies, governments, or multinational corporations as doing the same? Or does their piousness shine through naturally?

I have a negative opinion of him because the evidence suggests that he manipulated data and the subject selection process, used un-warranted invasive tests on children, didn't reveal his conflicting business concerns, wasted public funds et al.

Multinational drug companies have been caught repetitiously doing this and much much worse. Why aren't you going on and on about their behavior. Why this one individual? Biased perhaps. Influenced by your particular view about the way the world should be? Philosophical agendas? Does your ideology about darwinistic technological progress or socialist values influence your bias?

-btw- You obviously haven't been around the business world, have you? Many people make a decent living by training others how to speak, dress and act appropriately for careers.

Yes, I'm fully aware of what "scripting" is. Do you have any evidence that Andrew Wakefield is "scripted"? Or do you, again, want to go on your intuition and your unscientific feelings?

Even if he were, do you thing the CDC is above hiring PR firms and "scripting" their messages?

You should really get out more: it's a wide world and has all sorts of interesting people in it. Things aren't always what they appear to be on the surface.

You should watch the documentary "Toxic Sludge is good for you".

http://www.youtube.com/watch?v=yaMh8KGfkTM

Even though Orac has mentioned it before, let me give you a hint: It doesn't support your authoritarian views.

By augustine (not verified) on 09 Mar 2012 #permalink

Anonymous @ 158:

The "childhealthsafety" blog is hardly a reliable source; it is still claiming that Brian Deer is the "complainant" in the GMC case against Andrew Wakefield. "Complainant" is a specific legal role; even if Deer had made a specific, directed complaint about Wakefield, he did not become the "complainant" by doing so, any more than John Stone by using his blog to defend Wakefield in public became Wakefield's "public defender." Come back again when you have something we'd actually have reason to take seriously; that blog isn't it.

By Antaeus Feldspar (not verified) on 10 Mar 2012 #permalink

@ lurkers: I am only responding to the 'augurer' for your entertainment.

First of all, who ever said that pharmaceutical companies were above suspicion- certainly not me- corruption is a part of human nature, and it rears its ugly head more frequently when big money is involved- which is why governmental regulations and serious journalism are necessary. That doesn't mean these companies don't produce useful products that help millions of people. Malfeasance by these companies doesn't make AJW or any other woo-meister right.

The fact that I find AJW unsavory and what I think about his work are two different things: I'm a big girl, I can separate my feelings from what I know. However, his sales technique allows him to push his pseudo-scientific ideas on the public. And prior to ever reading any investigation about him, I suspected his project's results based on my studies. And yes, I believe he fixed data et al. I've been reading about him for a very long time.

As for "darwinistic technological progress","socialistic values", "philosophical agendas"- wow! I sound like a cross between Barack Obama and Tony Blair! Thank you!

The CDC gives out data-based information about public health: because you don't agree with it doesn't mean it's not real. I suppose you might call all education 'propaganda'. Too bad for you, it'll restrict how you function in the world and solve your problems.

Now about "toxic sludge", you've come to the wrong person about that: you see, I'm older than you are and this issue has been around for many, many years- as a matter of fact, 2 of my older relatives( in 2 separate countries) have been advocates for the clean-ups of important rivers since the 1970s: industrial pollution of the environment and related issues are no news to me.

Lurkers, at that I leave you. Perhaps Julian's response will be up by now. I think that A. doesn't like smart ladies, I suspect he'll not like a smart fellow like JF either.

By Denice Walter (not verified) on 10 Mar 2012 #permalink

I don't necessarily agree with this ruling, but either way it made Walker-Smith look pretty incompentent.

Denice Walter

Now about "toxic sludge", you've come to the wrong person about that: you see, I'm older than you are and this issue has been around for many, many years- as a matter of fact, 2 of my older relatives( in 2 separate countries) have been advocates

I don't care how old and wise you think you are and perceive your self to be. You obviously didn't watch or read "Toxic sludge is good for you".

It's not about toxic sludge at all. It's about corporations, government, and their use of Public relations firms to frame a message to get people like you to think a certain way.

The "lurkers" should note your "jumping to conclusions" mistake for future reference.

By augustine (not verified) on 10 Mar 2012 #permalink

Another disappointment for the vaccine poison lovers & drug fraud apologists was the ruling in Australia on the side of AVN (Australian Vaccination Network) against the HCCC ruling. Go the good guys! Can't wait for Wakefield to come up trumps.It's only a matter of time.

It's not about toxic sludge at all.

I watched it and most of it is about processed sewage being relabeled as "biosolids" as a PR exercise. I think that's a bit like a person unethically and fraudulently attempting to make large amounts of money out of a public health scare they have themselves orchestrated relabeling themselves as a caring, brave, maverick doctor.

It's about corporations, government, and their use of Public relations firms to frame a message to get people like you to think a certain way.

That's why it's important to look at the evidence. I noticed that the video presented no evidence at all. They just complain the the water company calls it "biosolids, a natural organic fertilizer" whereas it's really (according to them) "toxic sludge". Whether it is toxic depends on how it is used and can be assessed scientifically. Whether it is sludge is a matter of semantics. Isn't the term "toxic sludge" as emotionally manipulative as the term "recycled biosolids"? Aren't both terms intended to get people like me(obviously aug*st*ne is too clever to be manipulated in this way) to think in a certain way? Never mind the PR, show me the evidence.

By Krebiozen (not verified) on 11 Mar 2012 #permalink

@Pegasus, I suggest you read the ruling. The only reason that the HCCC Order was overturned was because the HCCC failed to come up with proof that the AVN had influenced the medical decision of anyone. In addition, the revocation of the AVN's license to fundraise by the Office of Liquor, Gaming and Racing still stands.
W.R.T. Andrew Wakefield's lawsuit, he sued Deer in the UK where the libel laws are a lot more plaintiff-friendly only to abandon it and pay Deer's legal costs. It is a lot harder to prove libel in the US, and Deer being Deer will have hard evidence to back up his claims.

@ Julian Frost: Pegasus is just parroting what he reads on the notorious anti-vax websites. My guess is he is *so impressed* by the legal and science *journalists* at AoA.

But, the difference is each doctor had the opportunity to appeal the GMC ruling. Walker Smith appealed and Andy didn't.

There was nothing in this recent court decision that in any way exonerates Wakefield.

Andy instituted suit (the first bite of the apple), against Deer in the U.K., discontinued it and was forced to pay all of Deer's legal costs.

The GMC decision to strike Andy from the register was based on the egregious harm he inflicted on his developmentally mentally disabled patients, his lack of medical ethics by paying kids at a birthday party to draw their blood, his COIs and other charges...that constituted the GMC finding of "Serious Medical Misconduct".

Wakefield left the U.K. a disgraced doctor whose license to practice was revoked by the GMC.

Wakefield alleges in his new lawsuit against the BMJ, Godlee and Deer, that he was defamed and his ability to earn money was a result of Deer's articles, written after he was found guilty of all charges of "serious medical misconduct", by the GMC. (The second bite of the apple).

If the case goes forward in the Texas State Court...or is heard in a Federal District Court, Andy will have to give sworn testimony during the "Discovery Phase" at an "Examination Before Trial"...and be subject to a criminal charge of perjury, if he lies.

No matter which court system hears the case, the "problem" of Texas' Anti-SLAPP law will loom large for Andy. He will have to pay all the court costs for the three defendants and might well be assessed punitive monetary damages, if this lawsuit is deemed to be a frivolous lawsuit.

Poor Dr. Walker-Smith. Does anyone think he is looking forward to being subpoenaed and testifying once again...now in a court in the United States?

@ Krebiozen:

Obviously, auggie will do or say anything to discount my observations. He's tries -like the woo-meisters I survey- to submit *proofs* that the government, corporations and media aren't to be trusted therefore: 'Don't trust the *elites* '( *comme tu et moi*). Actually, the very film he mentioned has been used by natural health advocates to harp upon the same point. Which is certainly ironic as woo itself is bolstered by PR - it has to be, because it can't claim data or consensus support.

Interestingly enough, one of the idiots I survey has been aided and abetted in his mis-educational campaign by a creator of *info-mercials* ( Steve Brown) - of all things! Shocking, isn't it? And another person I write about used his computer background in create adverstising via e-mail- he even describes it in his bio website! An additional woo-meister maintains a large staff that spreads his gospel far and wide- if you look at his website, job descriptions are shown: they aren't for nutritionists.

Basically, AJW is a miracle of PR himself: the guy is somehow able to walk around in public! After his public ( deserved) humiliation! He's a walking, talking ad for himself and his own personal brand of woo! Which was my point to begin with!

By Denice Walter (not verified) on 11 Mar 2012 #permalink

Skeptics unite! Now rearrange those chairs as the water flows into the ship!

Gee, and I thought only 9/11 truthers suffered such cognitive dissonance.

Silly me.

Robert, can you please explain your rather odd comment?

Who is suffering cognitive dissonance?

@Orac:

Brian Deer and the BMJ have filed an anti-SLAPP motion to dismiss Wakefield's defamation case. Popehat has an article on it here.

By Matthew Cline (not verified) on 11 Mar 2012 #permalink

Has any one sued Wakefield for malpractice or something like a class action lawsuit? He deliberately targeted MMR for his own financial purposes, committing fraud. I think one could agrue that his 'Callous Disregard' has led to those infant deaths from pertussis in California, the mumps outbreak two years ago in New York, and those dead Hib kids. Any one of those parents could easily blame him.

@ Julian Frost,

The ruling of the HCCC was not insignificant.The sceptics in Australia have been very disappointed by the HCCC ruling. Even Ken McLeod, one of the most outspoken sceptics,& the one who instigated the HCCC complaint,was quoted in one paper as saying he was very disappointed in the result.

The whole story about the AVN & WAkefield has not been given a fair go by the respective medias. The truth will one day come out.

Why is it that the parents of the kids involved with Wakefield have supported him through all this? Simply because he is not the evil incarnate being made out by the media & the medical profession.

I know one thing. Give me Dr Wakefield any day over Dr Offitt, the fool who stated that 10,000 vaccinations at once would cause no problems. Does he think everyone is gullible? Then again, he's making millions out of the gullibility, isn't he?

"The whole story about the AVN & WAkefield has not been given a fair go by the respective medias. The truth will one day come out."

Haven't you heard Pegasus, Wakefield was served with papers by the Defendants...they are seeking a dismissal. Andy will have to pay all court costs for the defendant and possibly punitive damages for bringing a frivolous lawsuit against the BMJ, Godlee and Deer...under the Texas anti-SLAPP Law.

"Why is it that the parents of the kids involved with Wakefield have supported him through all this? Simply because he is not the evil incarnate being made out by the media & the medical profession."

Why don't you read the accompanying 106 page document from Deer that is attached to the Motion to Dismiss? It is very informative about the possible "motives" of the parents who continue to support Wakefield. One might assume, after reading this 106 page document, that they were referred consecutively, that they *allowed* Andy to change the dates of onset of symptoms, to get compensation for their kids' disabilities. The diagnosis of some of the children was not autism...until they *consulted* Wakefield. I'm fast approaching an opinion about some of these parents, that ignorance of the invasiveness and ignorance of the medical indications was not a factor, when they agreed to multiple blood draws, colonoscopies, MRI scans and lumbar punctures.

I almost wish that the case goes forward, so that the court can find Andy criminally guilty of perjury.

Pegasus,
The truth will one day come out? It has. Wakefield was hired by Richard Barr to find problems with the MMR Vaccine and paid over 435,000 pounds to do so. He subjected vulnerable children to invasive tests without the proper authorisation and, when the data from the tests didn't fit his hypothesis, he cooked it.
As to why the parents of the Lancet 12 still support him, there are plenty of stories of people continuing to insist that someone who took them for a ride is an honest person, even in the face of rock solid evidence to the contrary.
Paul Offitt's quote was that we were capable of dealing with 10,000 vaccinations in one day, not simultaneously. And he was talking about antigen load. Learn the definition of analogy. Finally:

Then again, he's making millions out of the gullibility, isn't he?

Those deafening bangs you just heard were the sound of Irony Meters all over the world exploding. Wakefield not only earned a fortune for his study, he tried to set up companies to profit from the health scare he engineered.

GO ANDREW WAKEFIELD!
Vaccines=Poison/Death and
global eugenics by the globalists

GO ANDREW WAKEFIELD!

Hahaha so now we have a literal Andrew Wakefield cheerleader. Where are your pom-poms, william?

@ Julian Frost

10,000 shots in one day, not in one dose? And that make a difference? 10,000 hits of formaldehyde? 10,000 hits of polysorbate 80? Antigen load? Give me a break. Imagine if Dr Mercola had said that 10,000 shots of his "elixir" would cause no harm? Imagine the outcry from the sceptics. But what happens when a vaccine lover says ridiculous things? All the right wing drug-lovers come to his defence.

The first thing the sceptics ask when someone criticises vaccines are : "are you doctor?" If not, you are woo, quack, etc. If yes, then you are of the lapsed faith not to be trusted. Still a quack.Fairness is not in the sceptic's lexicon.

Paul Offit's claim was that a child's immune system can handle an antigen load equivalent to 10,000 vaccines per day, which he said in response to the claim that 10 vaccines in a day would overtax or overload a child's immune system. He didn't mean that a child could take 10,000 shots in a single day.

By Matthew Cline (not verified) on 11 Mar 2012 #permalink

Pegasus, learn the meaning of the saying "The dose makes the poison". Your body makes formaldehyde as part of the metabolic processes. In fact, your body makes more formaldehyde in just one second than is in the entire vaccination schedule. Yet we still live.
We are subjected to antigens each time we eat, drink or breathe. We survive. Yet somehow, a tiny quantity of antigens in an injection is regarded as "teh evilz". You are using the toxins gambit. We've heard it before, and we're most unimpressed.

"making millions"?

From depositions on Brian Deer's declaration about Wakefields Venture Capital companies he hoped to use to make money:

It is estimated that the initial market for the diagnostic will be litigation driven testing of patients with AE [autistic enterocolitis] from both the UK and the USA. It is estimated that by year 3, income from this testing could be about £3,300,000 rising to about £28,000,000 as diagnostic testing in support of therapeutic regimes come on stream.

Now I've seen endeless moaning about "conflicts of interest" with Paul Offit making around $5 million from the patent on the life-saving rotavirus vaccine he developed.

But......... £28 million pounds...? ($40 million)
..Is he being serious?
And that's not a "conflict"??

Just a few of the other things Wakefield did which were unconnected with the reasons behind the quashing of the Walker-Smith case:

The BMJâs conclusion that Wakefieldâs work was fraudulent plainly rested upon his covert and dishonest activities to create the appearance of a temporal link between MMR and autism. Specifically, but not exclusively, these included:
the concealment of the true source of the children as being from campaign groups and a lawyer, which created the grossest possible selection bias, fatally tainting the paperâs concluding interpretation;
the concealment of the predetermined goal of proving a ânew syndromeâ, which created the grossest possible observer bias;
the coaching of parents before they came to the hospital;
the representation of methods as findings;
the manipulation of the number of parental testimonies blaming MMR;
the baseless claim that all children suffered from regressive developmental disorders;
the omission of critical information, such as diagnoses of constipation and blood test results, that might have put peer reviewers, editors and readers on their guard;
and the alteration and/or intentional and uncorrected misreporting of individual childrenâs histories (such as in the cases of child 1, child 7 and child 11, set out proportionately in this declaration).
The paper also falsely claimed that the investigations children underwent had been approved by the Royal Free hospitalâs ethics committee, an institutional review board.

(Brian Deer declaration)
And that's just the basis for the fraud allegation. The professional misconduct GMC charges included a raft of other stuff, including the dishonesty about funding sources, the callous disregard in paying kids for blood tests for his research, his directing clinical tests even though he was not on a clinical contract and could not do so, etc etc.

As I often do, I have made a roundup of posts about both the UK high court's ruling on Professor Walker-Smith and Brian Deer's anti-SLAPP suit. I've included this post in the list, both at Thinking Person's Guide to Autism (where the list will be static) "What the UK High Court's Ruling on John Walker-Smith Means and Doesn't Mean",

http://thinkingautismguide.blogspot.com/2012/03/what-uk-high-courts-ruling-on-john.html

and at my own blog, I Speak of Dreams "UK High Court Quashed Rulings Against John Walker-Smith; Means NOTHING about Andrew Wakefield"

http://lizditz.typepad.com/i_speak_of_dreams/2012/03/walker-smith-ruling-means-nothing-about-wakefield.html

I'll continue to update the latter post daily.

IANAL, but my understanding of Walker-Smith's appeal is that it succeeded solely because it created reasonable doubt (in Judge Mitting's mind, at least) that W-S had the mens rea (guilty mind) necessary for his actus reus (guilty act) to constitute serious professional misconduct. In other words, nothing in the appeal disputes that what Walker-Smith was wrong; it simply suggests that he might not have known it was wrong.

Now, others have analyzed in far better detail than I can (because IANAMD, either) why Mitting's idea that Walker-Smith could have not known that he was doing was wrong seems far-fetched. I'll just point out that there is no way Wakefield's state of mind can be determined to be innocent, from what Walker-Smith asserts about his own state of mind. Walker-Smith's appeal can harm Wakefield, however; unless I misread, in several places W-S essentially asserts "I didn't know that I was doing something that was in the circumstances inappropriate because I was relying on representations made by Wakefield about the circumstances." Doesn't sound like that'll do anything helpful for Wakefield.

By Antaeus Feldspar (not verified) on 12 Mar 2012 #permalink

@Julian Frost,

10,000 antigen loads harmless? Who are trying to kid? How about you being the test subject & we'll give you 10,000 antigen loads in one day? Harmless? You'd run for cover. Obviously Offitt has fooled many people.

The quality of a substance is never changed by its quantity. A drug is a poison. A rose by any other name is still a rose.

It's simply not common sense to give a day old baby an injection (Heb B Vaccine) with strong chemical irritants in it, for a disease which it is highly unlikely to get.

10,000 antigen loads harmless?

Perhaps Pegasus lives within a plastic bubble and has no idea how many antigens impinge on a normal person in one week of normal life.

By herr doktor bimler (not verified) on 12 Mar 2012 #permalink

Pegasus:

How about you being the test subject & we'll give you 10,000 antigen loads in one day? Harmless?

How many antigens do you come into contact with per day? What about the amount of antigens does a newborn come into contact with during vaginal birth? Did you know you have many times more bacteria in your body than you have cells?

Are you like Thingy in thinking that the world is sterile, and the only way you get infected is on purpose?

10,000 antigen loads harmless? Who are trying to kid? How about you being the test subject & we'll give you 10,000 antigen loads in one day? Harmless? You'd run for cover.

Pegasus, do you know what an antigen is? I suspect that you don't; referring to "10,000 antigen loads" a) as if that phrase had any meaning, and b) as if it meant the same thing as "an antigen load equivalent to that of 10,000 vaccines" strongly suggests that you have no actual understanding of what antivax claim Paul Offit was responding to, or what Offit actually said about what a child's immune system could tolerate, or how one relates to the other. Are you in fact even trying to understand the terms you're throwing around, or are you simply (and dishonestly) starting from the conclusion "Paul Offit is wrong about antigens" and trying to reason backwards from there to figure out what antigens are?

By Antaeus Feldspar (not verified) on 12 Mar 2012 #permalink

The quality of a substance is never changed by its quantity.

Water. Salt. Glucose. Potassium. Calcium. I could go on.

By dedicated lurker (not verified) on 12 Mar 2012 #permalink

@pegasus

"The quality of a substance is never changed by its quantity."

Sure it is, quorum sensing bacteria are an example.

Unvaccinated goons in an otherwise vaccinated population are another, as you get more of them they become more dangerous.

The quality of a substance is never changed by its quantity. A drug is a poison.

Funny how the manufacturers of Chlorox bleach haven't figured that out. We use their directions when purifying drinking water during wilderness medical training.

@Pegasus:

The quality of a substance is never changed by its quantity. A drug is a poison.

Just to finish the dogpile on the rabbit, digitalis is a substance used to treat heart disease. At large doses, it can stop the heart. Paracetamol is an analgesic but if I swallowed two containers of paracetamol pills, my liver would fail.
The dose makes the poison.

"Just to finish the dogpile on the rabbit, digitalis is a substance used to treat heart disease. At large doses, it can stop the heart."

Damn straight it can stop the heart. But, it saved my 5 lb. infant's life, when I dosed him with Lanoxin through a feeding tube.

The dose makes the poison.

The dose doesn't change the quality. But I agree it changes the effects.

Also, antigens our bodies are exposed to come through natural contact/exposure.

There is nothing natural about directly injecting multiple chemicals, attenuated/live viruses & adjuvants into a one day old baby's body, or for that matter, any body.

It simply defies belief that intelligent people can believe it is good "science".

Then again, science today becomes nonsense tomorrow & vice versa. Medicine is very loosely termed "science"

And lastly, how often is the majority wrong? History is replete with such examples from all areas of life, including medicine. I honestly believe there will come a day when vaccinations are looked upon as something from the dark ages of medicine, when fear & voodoo dominated, & when the drug industry with all its avarice & fraud capitalised on medicine's weaknesses & limitations.

@Pegasus - the vaccination program has reduced incidence of vaccine-preventable diseases by 95 - 99% (and eliminated two diseases entirely, while almost wiping out polio as well). Not exactly a bad track record & certainly better than the alternatives.

Smallpox alone killed more individuals than all of humanity's wars combined - your arguments are unsupported and entirely irrational.

Also, antigens our bodies are exposed to come through natural contact/exposure.

If you want to disagree with the sentences about antigen exposure that Offit and his co-authors wrote in their 2002 article, it would make more sense if you actually read the article first.

By herr doktor bimler (not verified) on 13 Mar 2012 #permalink

Also, antigens our bodies are exposed to come through natural contact/exposure.

There is nothing natural about directly injecting multiple chemicals, attenuated/live viruses & adjuvants into a one day old baby's body, or for that matter, any body.

It simply defies belief that intelligent people can believe it is good "science".

How does not being "natural" preclude it from being good science? Are you claiming that every single thing that you would agree to be good science is "natural" and you can't find any exceptions? Air travel? Buildings over five stories high? Combustion engines? Organ transplants? Which of those is "natural"?

See, the question we're more interested in than "is it natural?" is "does it work?" Vaccines work, and neither arguments from personal incredulity nor complaints that they aren't "natural" alter that fact.

By Antaeus Feldspar (not verified) on 13 Mar 2012 #permalink

Pegasus:

Also, antigens our bodies are exposed to come through natural contact/exposure.

Did you never, as a child, fall down and scrape your knee? A few months ago, while washing up, I cut my thumb on my large kitchen knife. My hand was submerged in the sink and dirty water containing LOADS of antigens entered the cut. I had to put antiseptic cream on it to prevent an infection.
Your comments about "natural exposure" are laughable.

The dose doesn't change the quality. But I agree it changes the effects.

And since the effects are what's relevant, you've just obliterated your own claim by admitting this fact.

Also, antigens our bodies are exposed to come through natural contact/exposure.

So the body somehow knows to react completely differently to antigens that come in via the puncture of a thorn, or a bee sting, than the puncture of a needle?

There is nothing natural about directly injecting multiple chemicals, attenuated/live viruses & adjuvants into a one day old baby's body, or for that matter, any body.

Nor is there anything natural about the computer you're typing on. See "naturalistic fallacy." There is no reason whatsoever to believe that something "natural" is safe/good and something "unnatural" is unsafe/bad.

And lastly, how often is the majority wrong? History is replete with such examples from all areas of life, including medicine.

When we're talking about a scientific consensus based on data? Well, I can't think of ANY cases off the top of my head.

I honestly believe there will come a day when vaccinations are looked upon as something from the dark ages of medicine, when fear & voodoo dominated, & when the drug industry with all its avarice & fraud capitalised on medicine's weaknesses & limitations.

There are also people who believe the earth is flat. Yours is just as ludicrous.

Pegasus, then explain very carefully your plan to prevent diphtheria, tetanus and pertussis in babies. Tell us exactly how the DTaP is more dangerous than those diseases, include how it is more toxic than tetanospasmin.

Instead of making statements on the evils, show you actually understand what you are saying. Tell us how we can better keep babies from getting sick from those diseases. Show what can be done to prevent this again: Diphtheria in the former Soviet Union: reemergence of a pandemic disease..

"I honestly believe there will come a day when vaccinations are looked upon as something from the dark ages of medicine"

You're probably right, but until we develop genomic manipulation and nanomedicine, this will have to do.

Someday we will also look back and laugh at chemical-propelled rockets, as we traverse the galaxy with our antimatter-powered warp drives.

By Cynical Pediatrician (not verified) on 13 Mar 2012 #permalink

And lastly, how often is the majority wrong?

Much less often than the minority is.

Pegasus:

"It's simply not common sense to give a day old baby an injection (Heb B Vaccine) with strong chemical irritants in it, for a disease which it is highly unlikely to get."

How *likely* (using your common sense), would it be for a newborn whose mother is a carrier of the hepatitis B virus, to become infected and...how likely would it be for that infant to remain infected for a lifetime? (Hint: think about "vertical transmission").

How *likely* (using your common sense), would it be for a young child to become infected with the virus through exposure to another infected child or an infected household contact and, how like would it be for the infected child to remain infected for a lifetime? (Hint: think about "horizontal transmission").

How *likely* (using your common sense), would it be for anyone who is chronically infected with the virus to die from:

-fulminant liver disease?

-liver cancer?

Here's a chapter from a hepatology textbook...don't even bother with the "e" antigen or co-infection with the Delta virus.

http://www.hepatologytextbook.com/hep_chapt02.pdf

Also, antigens our bodies are exposed to come through natural contact/exposure.

The thing is, Offit et al. never stipulated whether an infant is exposed to antigens through contact, or natural punctures, or artificially. They were specifically making a point about the capacity of the human immune system to respond to more than one antigen at a time.

So Pegasus seems to be shouting about what he or she believes Offit said, without bothering to read his actual words, even though the paper is on the Internet and everything.
This isn't very honest.

By herr doktor bimler (not verified) on 13 Mar 2012 #permalink

Lawrence,

The mortality of all infectious diseases was declining well before vaccination programs, in fact from 1890 on. It is mischievous to imply that vaccines were responsible for saving us from dying from infectious diseases. There are many medical doctors who admit this, & the facts bear this out.

Pegasus:

Did you understand the questions I posed to you about hepatitis B virus and the vaccine that provides protection?

Did you read the short chapter in the hepatology textbook that I linked?

Does your "common sense" trump the collective knowledge of researchers and infectious diseases specialists, about this blood-borne virus?

Tell me which "doctors" acknowledge that vaccines have not dramatically decreased morbidity and mortality? Please provide some citations.

Pegasus:

The mortality of all infectious diseases was declining well before vaccination programs, in fact from 1890 on.

Smallpox vaccination began with Edward Jenner in the late 18th century.

It is mischievous to imply that vaccines were responsible for saving us from dying from infectious diseases.

Even with the best treatment modern medicine has to offer, people still die from vaccine preventable diseases. Last year, a 22 year old woman in Australia died from Diphtheria. Her parents hadn't had her vaccinated.
Vaccines helped us by causing the rate of infections to plummet, in most cases by over 90%. One of the other regulars has access to a table showing measles rates before and after vaccination was introduced. Even I was gobsmacked by how effective it was.

It is mischievous to imply that vaccines were responsible for saving us from dying from infectious diseases.

No, it is mischievous to ignore rebuttals and simply switch to new, albeit equally tired, talking points.

Pegasus, there are still babies dying from pertussis. Now please answer my question on how you would prevent that. Also read the article I posted on diphtheria in the former Soviet countries.

Pegasus said:

Lawrence, the mortality of all infectious diseases was declining well before vaccination programs, in fact from 1890 on. It is mischievous to imply that vaccines were responsible for saving us from dying from infectious diseases. There are many medical doctors who admit this, & the facts bear this out.

But what Lawrence actually said was this:

the vaccination program has reduced incidence of vaccine-preventable diseases by 95 - 99% (and eliminated two diseases entirely, while almost wiping out polio as well). Not exactly a bad track record & certainly better than the alternatives.

So who is being "mischievous" here Pegasus?
Lawrence, who quite correctly said that vaccination has reduced the incidence by 95-99%*, or you who tried not so subtly to indicate Lawrence claimed vaccination had reduced mortality and had "saved us all" (something no doctor I have ever encountered has claimed, ever)?

Straw man, goal post shift and non-sequitur all in a single sentence. Pegasus, you win the fallacy bingo internetz for your sterling (though lame) effort!

*http://jama.ama-assn.org/content/298/18/2155.abstract

There is nothing natural about directly injecting multiple chemicals, attenuated/live viruses & adjuvants into a one day old baby's body, or for that matter, any body.

Know what else isn't natural? Using a computer to argue with strangers on the Internet, yet here you are. Our entire modern lifestyle is completely "unnatural", yet I seldom hear anybody arguing that we'd be better off going back to living in caves and revert to the hunter-gatherer lifestyle (trendy "paleo" diets notwithstanding.)

My larger point is that saying vaccination is dangerous because it's "unnatural" is completely meaningless.

By Edith Prickly (not verified) on 14 Mar 2012 #permalink

Fuck you, you miserable prick.

Pegasus: Another worshiper of the Walt Disney version of nature.

This is real life, not a feel good cartoon. Nature has good and bad points. Technology has good and bad points. The world is not starkly divided into black and white, no matter how much you crave that simplicity. It's all about which treatments have benefits that outweigh their risks, not partisan loyalties to arbitrarily defined "camps." This obsession with "natural" versus "artificial" is nothing but a distraction.

So, what do you suggest that has a better set of benefits and/or smaller risks than vaccination?

My larger point is that saying vaccination is dangerous because it's "unnatural" is completely meaningless.

Exactly.
Let's see what else is "unnatural"?
Well for starters, there's antibiotics, hospitals and surgery. Flush toilets. Tubes of toothpaste. Man made electricity. Planes, trains and automobiles.

By Sauceress (not verified) on 14 Mar 2012 #permalink

And lets see what else is "natural": ricin, botulism, belladonna, measles, cholera, strychnine, deadly nightshade, hemlock, and on and on.

Pegasus, in case you forgot: Please explain very carefully your plan to prevent diphtheria, tetanus and pertussis in babies. Tell us exactly how the DTaP is more dangerous than those diseases, include how it is more toxic than tetanospasmin.

Clearly there's good unnatural and bad unnatural, and there's a simple test to tell the difference.

Is it something I like, like surgical anesthesia or distilled alcohol? Good unnatural!

Is it something I don't like, like immunization? Bad unnatural!

Is Evan commenting on anything in particular, or is it just a really excellent example of bad trolling?

flip, Evan is exhibiting his general intelligence.

Chris, perhaps Pegasus thinks babies don't get any infections (they all have maternal IgG)
See what I did there?

PS The Aluminati bragging rights are all yours. Kudos, big time.

Is'nt it fascinating the silence from the BMJ shills after the High Court ruling, all they have left is some internet blogs to discuss "science". LOL? I'm going to get some popcorn. The british court ruling makes it next to impossible for the texas courts to throw out Wakefield's case. I hope Walker-Smith and every Dr involved sues the crap out of them all GMC, BMJ. You poor sad creatures. Does it make you feel better to comment here on how brainless you really are?

By Wakefield (not verified) on 14 Mar 2012 #permalink

Isn't.

Wakefield is a proven fraud. 10 of the 12 co-authors of his paper retracted. So did the magazine it was published in.

They haven't changed their minds. Neither has anyone else.

He's still very much struck off, and still a lying scumbag who tried to make himself rich from phony scare stories and a juicy patent.

But hey - Big Pharma only thinks of the money!

I bet you £1000* Wakefield gets absolutely nowhere with his utterly frivolous lawsuit, except impressing thick little fanbois like yourself so much that you even use his disgraced laughing stock of a name as your own.

*I'm in the UK. Perfectly legal, I can set it up on Betfair if you like.

@Wakefield Troll:

Is'nt it fascinating the silence from the BMJ shills after the High Court ruling

If by "silence" you mean multiple blog posts showing why Walker-Smith's successful appeal helps Wakefield not one bit, then yes.
The british court ruling makes it next to impossible for the texas courts to throw out Wakefield's case.
Wrong again. The former involves a striking off, the latter involves a libel suit. And given that Deer and the BMJ have filed an anti-SLAPP motion, it's not unlikely that it will be thrown out.

You poor sad creatures. Does it make you feel better to comment here on how brainless you really are?

Irony Meter goes BOOM!!

@Wakefield Troll:

Is'nt it fascinating the silence from the BMJ shills after the High Court ruling

If by "silence" you mean multiple blog posts showing why Walker-Smith's successful appeal helps Wakefield not one bit, then yes.
The british court ruling makes it next to impossible for the texas courts to throw out Wakefield's case.
Wrong again. The former involves a striking off, the latter involves a libel suit. And given that Deer and the BMJ have filed an anti-SLAPP motion, it's not unlikely that it will be thrown out.

You poor sad creatures. Does it make you feel better to comment here on how brainless you really are?

Irony Meter goes BOOM!!

Never understood the 'Big Pharma' conspiracy on this one either.

One Queer Ranter obviously thinks all doctors are basically being bribed by drug manufacturers, even falsifying research to get rich. The bastards!

Yet when one of them is caught red-handed doing EXACTLY that (to the tune of £430,000), he's the messiah!

God help any anti-vaxxer who ever has an enema, there would be nothing left of them.

(I think the anti-vaxxers are the real Big Pharma shills anyway. Vaccines are low-profit, less than 10% of drug sales, and prevent plenty of people needing hugely expensive emergency treatment. Big Pharma obviously wants them to fail, pays corrupt doctor £430,000 to fake some research... all makes sense.)

Well to be fair, it wasn't actually BigPharma who paid Wakers the $750k, but the litigation lawyers/legal aid. Still comes to the same thing though - research falsification to distort the clinical literature base and generate yet more income.

What many people don't realise is that Wakers wanted to become a BigPharma head honcho himself - even setting up venture capital companies to flog his fake cures and vaccines for MMR damaged children which had a forecast £26 million income.

If that isn't Big, I don't know what is.

Says Lawrence: the vaccination program has reduced incidence of vaccine-preventable diseases by 95 - 99% (and eliminated two diseases entirely, while almost wiping out polio as well). Not exactly a bad track record & certainly better than the alternatives.

Sorry DT - to say that vaccinations have resulted in up to 99% less incidence is an absolute hoot.Vaccinations were not even around when these diseases started to decline (circa 1890), due to improved social conditions, sanitation, refrigeration, less crowded housing etc. And these improvements were not for the main instigated by the medical profession.

The trouble with most sceptice is that they have almost psychotic emotional attachments to what falsely goes by the name of SBM.

Getting off vaccinations, where is the science behind mass prescribing a chemotherapeutic drug (fosomax) to asymptomatic women labelled osteopenic? Imagine if CAM practitioners were causing such devastating problems with their remedies to asymptomatic women? You would be calling for their necks, but not a word about fosomax from you.

Every year we hear more horror stories about the latest greatest blockbusters being sent to the black box or worse eg HRT, Vioxx, statins last week.

Do I ever hear from you guys about such non-science. What about the JAMA article 1999 stating over 100,000 Americans are killed yearly by properly-prescribed drugs (read Death by Prescription by Dr Ray Strand). Even if the subsequent study which refuted those exact figures was true, it still is admitted that tens of thousands perish at the hands of the Pharma-Medical love-affair with drugs every year. Admittedly, many people are very sick & elderly, but thousands are not in that category & are given drugs inappropriately, often causing death.

The drug company GSK just got fined 3billion for fraud. Which was one quarters profit- the cost of doing business. Was anyone jailed? Were they disbarred from doing business with the Fed's? Any peep out of you guys?

Talk about irony meters.

No wonder people are becoming very disillusioned with modern medicine, & turning to people like Mercola, Adams et al.

@Pegasus:

Vaccinations were not even around when these diseases started to decline (circa 1890), due to improved social conditions, sanitation, refrigeration, less crowded housing etc.

Edward Jenner began his experiments with vaccination in 1796. That's almost 100 years before 1890. Also, many diseases are airborne (e.g. Measles, TB, Smallpox, Chickenpox) and wouldn't be prevented by better sanitation.

to say that vaccinations have resulted in up to 99% less incidence is an absolute hoot.

One of the regulars has a graph showing the rate of infection of Measles. 10 years after vaccination was introduced, the rate had fallen by over 90%.
You are a poster for the arrogance of ignorance.

I also point out that Pegasus has obviously not worked in an acute care hospital. Many of the in-patients I work with are well over 75 years. But many of the younger patients (think 50-60) are there from abusing their bodies. I am talking specifically about drinking into liver failure. Much more common than Pegasus could even imagine. I am not talking homeless drunks. One patient had a PhD - liver failure. Do you have any idea how hard it is to stabilize someone who's liver has been shot to hell? Seriously, these people are teetering on the edge before they get into the medical system.
Get educated. Volunteer at your local hospital, see who is being cared for and see for yourself that these people are not dying wantonly due to drug overdoses. Seriously.

I'm beginning to suspect that Pegasus is just trolling for shits-&-giggles, and is not really as stupid and discourteous as his off-the-topic posts would have us believe.
Imagine my disillusionment.

By herr doktor bimler (not verified) on 15 Mar 2012 #permalink

@Pegasus - you really need to learn basic medical definitions and the difference between "incidence" and "mortality."

Did mortality rates start dropping in the 1890's - yes they did. I wonder why? Could it have anything to do with the better medical treatments, perhaps? Of course, we were able to keep people alive better once doctors had a better understanding of disease vectors, treatments became available (and better) at preventing or alleviating things like opportunistic infections (like pneumonia).

Now, did the "incidence" rate of infection drop too? In some cases, like with those disease spread by infected water sources, yes they did - as sanitation did get better. But for diseases that are airborne, this had no effect. It was only after the advent of the vaccines did these diseases see a decrease in "incidence" and in some cases, a decrease of 95 - 99%.

Now run along & try reading an actual medical text - might be useful (or not).

Pegasus:

Vaccinations were not even around when these diseases started to decline (circa 1890), due to improved social conditions, sanitation, refrigeration, less crowded housing etc.

Actually, crowded housing has *increased* since 1890, not decreased. And it's increased a lot, allowing the human population to grow from under 2 billion (we hit 2 billion in 1927) to an estimated 7 billion today. Urbanization has been a major part of that.

But it is true that there have been greatly improved social conditions, sanitation, and refrigeration, along with a better appreciation for food safety and water quality, and these have drastically reduced the incidence of diseases such as cholera, which is spread predominately through contaminated drinking water. Cholera is nearly unheard of in America, but Haiti is now suffering a disastrous cholera epidemic due to a lack of access to clean water. But it doesn't do much to help diseases which are airborne, such as measles or pertussis, and while you'd *expect* it to help reduce fecal/oral diseases such as polio, the results there are surprising -- actual incidence of polio decreases dramatically, but not completely (as it is more contagious than cholera), and those who do get the disease get a much worse case of it. Sanitation is vitally important, but it actually made polio worse; it wasn't until vaccination came along that polio was extirpated from developed countries. Diseases like rabies also cannot be eliminated through sanitation; sanitation can help, by reducing the attractants that bring wild animals into contact with humans and livestock and thereby reducing opportunities for transmission, but it can't eliminate it -- bats, for instance, are ubiquitous, and a fairly serious carrier of rabies due to the long period before an infected bat becomes symptomatic. I suppose you can hope for white nose disease to wipe them out, but then you'll have to worry more about west nile disease and other mosquito-borne illnesses for which there is presently no vaccine, and no treatment beyond supportive care. Rabies cases have gone way down thanks to vaccination of domestic animals; they can't wipe out the disease that way, but they do provide a major buffer between humans and the wild reservoir -- most human rabies is transmitted from an infected domestic animal, so vaccinating them prevents that.

Getting off vaccinations, where is the science behind mass prescribing a chemotherapeutic drug (fosomax) to asymptomatic women labelled osteopenic? Imagine if CAM practitioners were causing such devastating problems with their remedies to asymptomatic women? You would be calling for their necks, but not a word about fosomax from you.

I don't recall Fosamax specifically being discussed here, but I know some of Orac's blogging buddies have tackled the thorny question of just what really constitutes osteopenia, or at least osteopenia worthy of treatment. There is very serious reason to be concerned that osteopenia is being overtreated.

That's not to say Fosamax is worthless, though. It was developed out of experiments to counteract a very specific type of osteoporosis -- microgravity-induced osteoporosis. Long-duration astronauts suffer considerable bone loss in space, and exercise with various resistive devices (such as the famous COLBERT treadmill!) seems to only partially mitigate this. Last winter, NASA and JAXA (the Japanese space agency) released the results of a trial they'd been doing using Fosamax on ISS resident crews. They found it helped considerably -- 14 control astronauts suffered an average of 7% bone loss in the femur, and 5% in the pelvis. Those who did take Fosamax had an average of 1% loss in the femur, a surprising 3% increase in the pelvis, and very low urine calcium concentrations. (Astronauts tend to suffer a lot of kidney stones; the calcium from their bones has to go somewhere.) The downside? Effectiveness declined over time, which means it's not yet ready to support a two-year mission, and it can't yet eliminate the need for hours of exercise every day. (Exercise will always be needed -- there's no drug to counteract the effects of microgravity on the circulatory system and the muscles, for instance -- but it could be more varied without having to focus so obsessively on the bones.)

So the drug does work, and for people facing actual osteoporosis, it can make a major difference in quality of life -- and even life expectancy, since fractures in the elderly are so often the start of a major decline. But it's usefuless in cases of mild osteopenia is not, in my opinion, demonstrated.

By Calli Arcale (not verified) on 15 Mar 2012 #permalink

No wonder people are becoming very disillusioned with modern medicine, & turning to people like Mercola, Adams et al.

I for one do wonder about this--what are those people thinking?. The finding against Glaxo doesn't speak at all to the safety or efficacy of its products--they were fined for tax violations involving transfer pricing between foreign and US subsidiaries of GSK)

By what rational arguemnt does it make sense to eschew a treatment that's been shown to be both safe and effective following extensive pre-clinical and clinical trials, to instead embrace treatments that have either a) not been shown to be safe and effective or b) have actualy been shown to be unsafe and/or ineffective, because the company producing was fined for its accounting practices?

Pegasus:

Sorry DT - to say that vaccinations have resulted in up to 99% less incidence is an absolute hoot.Vaccinations were not even around when these diseases started to decline (circa 1890), due to improved social conditions, sanitation, refrigeration, less crowded housing etc. And these improvements were not for the main instigated by the medical profession.

I see you have refused to answer my question on your plan (with evidence) on how to prevent pertussis in babies. Well, how about my next question?

You are joking about the reduction of incidence, now you get to prove it. I have data from the American census from 1912 to the 1990s of measles incidence (also known as morbidity). Now tell me, with actual documentation, why the rates of measles in 1970 is only 10% of what it was in 1960? Do not discuss any other country, do not change the decade and do not discuss deaths (morbidity). Answer the question as it was asked. Here is the data:

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

Now, really, why are measles rates in 1970 only 10% of what they were in 1960?

Now, really, why are measles rates in 1970 only 10% of what they were in 1960?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1919891/pdf/pubhealthrepori…

"For centuries the measles virus has maintained a remarkably stable ecological relationship with man. The clinical disease is a characteristic syndrome of notable constancy and only moderate severity. Complications are infrequent, and, with adequate medical care, fatality is rare."

By augustine (not verified) on 15 Mar 2012 #permalink

Incidence in 1970 10% of what it was in 1960? That's easy--public school's introduced New Math in the 1960's. :)

Pegasus,

The trouble with most sceptice is that they have almost psychotic emotional attachments to what falsely goes by the name of SBM.

We do have a curious attachment to evidence and facts.

Getting off vaccinations,

You mean you want to change the subject because you are losing the argument so spectacularly?

where is the science behind mass prescribing a chemotherapeutic drug (fosomax) to asymptomatic women labelled osteopenic? Imagine if CAM practitioners were causing such devastating problems with their remedies to asymptomatic women? You would be calling for their necks, but not a word about fosomax from you.

You are not the first to come here and rant about Fosamax for reasons I do not really understand. Has Mercola or another CAM guru condemned it as an evil drug recently or something?

The thing about osteopenia is that it often leads to osteoporosis, which is also asymptomatic until the patient suffers a fracture. If that fracture is of the hip or the neck of the femur in an elderly person the consequences are very serious, with significant mortality. There are 329,000 hip fractures every year in the USA (PMID 18042916). Fosamax reduces the risk of hip fracture in post menopausal women with osteoporosis by 50% (PMID 11434454). It also reduces the incidence of fracture in osteopenia by about 60% (PMID 15757015) though you need to treat about 200 patients to prevent one fracture. The clinical benefits are clear even in osteopenia but it may not be cost effective.

Side effects are uncommon and generally mild. "Uncommon side effects that have been noted with wide clinical use include osteonecrosis of the jaw, musculoskeletal complaints, and atypical fractures. The numbers of events are small, and a clear cause-and-effect relationship between these events and bisphosphonate treatment has not been established." (PMID 20173017).

This is a drug with few side effects that could prevent over 100,000 hip fractures every year, not to mention other fractures it can prevent. It sounds pretty good to me. Have I missed something?

Every year we hear more horror stories about the latest greatest blockbusters being sent to the black box or worse eg HRT, Vioxx, statins last week.

These warnings are usually when a drug has been in use for a while and rare side effects in small subgroups of people become noticeable. It doesn't mean that the risks of the drug overall exceed its benefits. The statin warning I think you are referring to, for example, are for a small increase in the risk of diabetes, a meta-analysis suggests 9%. There is also a possible risk of transient memory and cognition problems. The reduction in strokes and heart attacks from statins far outweighs these small risks.

Do I ever hear from you guys about such non-science. What about the JAMA article 1999 stating over 100,000 Americans are killed yearly by properly-prescribed drugs (read Death by Prescription by Dr Ray Strand).

You mean Lazarou et al 1998 (PMID 9555760)? It has been discussed here at length several times. You might use the search box top left. Short version is that he extrapolated from a few deaths mostly in the 60s and 70s to the entire US hospital population in 1994. Even if he was right (which he wasn't) things have changed a lot in the last few decades.

Even if the subsequent study which refuted those exact figures was true, it still is admitted that tens of thousands perish at the hands of the Pharma-Medical love-affair with drugs every year. Admittedly, many people are very sick & elderly, but thousands are not in that category & are given drugs inappropriately, often causing death.

How many people's lives are saved, or dramatically improved by pharmaceutical drugs? Be sure to include anticoagulants, diuretics, digoxin, antibiotics, antiretrovirals, immunosuppressants, thyroxine, insulin, non-steroidal anti-inflammatories and chemotherapy drugs for cancer. They are just the tip of the iceberg yet anticoagulant drugs alone save hundreds of thousands of lives every year.

"Often causing death"? Fatalities in young and relatively healthy people due to adverse drug reactions or errors are rare enough to make newspaper headlines. This has happened a couple of times in hospitals I have worked at. It's regrettable, and should never happen, but it certainly doesn't happen "often".

By Krebiozen (not verified) on 15 Mar 2012 #permalink

"Incidence in 1970 10% of what it was in 1960? That's easy--public school's introduced New Math in the 1960's. :)"

No, no, no....the rates of measles in 1970 were only 10 % of what they were in 1960..."due to improved social conditions, sanitation, refrigeration, less crowded housing etc."

In 1959, we all lived in mud huts, used filthy outdoor privies, bathed and drank water from the same stream and ate rotten food.

During the next decade, we all moved into houses with indoor plumbing connected to pure water and to municipal waste disposal systems. Edison invented electricity in that decade and someone started manufacturing refrigerators:-)

-FTFY Pegasus Troll

You had a mud hut?

Kids today got it easy--in 1959 we lived in a brown paper bag on the slope of a landfill. Every day we got up two hours before we went to bed, drank a glass of cold toxic waste and walked 2 miles to and from school, barefoot over ground glass.

Uphill, both ways.

JGC -- and when we got home, our mum and dad would kill us and dance about on our graves. But you try to tell the kids today that, and they won't believe you.

By Calli Arcale (not verified) on 15 Mar 2012 #permalink

They won't believe you

They won't. The reference to that sketch is particularly apposite as it was written in 1967.

By Krebiozen (not verified) on 15 Mar 2012 #permalink

Krebiozen, don't let Pegasus get out of answering on subject questions by changing the subject.

While I ignore him, I see Little Augie does not know what the difference is between morbidity and mortality . Even though I specifically said "do not discuss deaths (morbidity)", he comes up with a "fatality is rare" quote. What an idiot.

JGC...our mud hut was on top of that landfill and every time you used that outdoor privy, the run-off landed in the simmering cauldron of rotten meat.

You had schools and you actually slept? While you were being educated I was sent to scavenge scraps of food and other detritus from that toxic landfill.

Kids today got it easy--

Even though I specifically said "do not discuss deaths (morbidity)", he comes up with a "fatality is rare" quote. What an idiot.

Then I shall ask you to not use death as a sales pitch or scare tactic. Can you do that?

Are the insults really necessary to get your points across?

By augustine (not verified) on 15 Mar 2012 #permalink

@ Chris:

While I've decided not to engage the creature: there's something else he doesn't understand ( amongst myriad other things)-you can use an anecdote to illustrate what we already know
from research-e.g. an illness is caused by a particular virus *and* Dr Wilson ( a real person) contracted it from an accidental needle stick.

Which leads to the rather obvious: if you're citing the consensus opinion - all you have to do is say that- SBM knows that. Nothing controversial there- you have the entire body of literature. You only need to *prove* your points when you attack consensus. Suppose I say that depression has been associated with neuro-transmitters like serotonin, I don't need to cites volumes that support this view but if someone says, "No. Serotonin has nothing to do with depression." That's an entirely different story.

By Denice Walter (not verified) on 15 Mar 2012 #permalink

Chris,

Krebiozen, don't let Pegasus get out of answering on subject questions by changing the subject.

He's not going to answer your question Chris. He can't without admitting that vaccines work, can he? I just wanted to point out that even when he changes the subject he's mistaken.

By Krebiozen (not verified) on 15 Mar 2012 #permalink

I know, but sometimes the question makes them go away. If he does not go away, we can continue to tell his he needs to prove his assertions. And good point.

He's not going to answer your question Chris. He can't without admitting that vaccines work, can he?

The question was about the measles vaccine and cases, not all vaccines and endpoint effectiveness.

And it's the wrong question. It could be shown that arsenic is effective against a particular disease. The question is "is arsenic effective? Does the risk of arsenic outweigh the projected benefit of arsenic?"

The clinical question is "Does one need arsenic?"
That is debatable.

"For centuries the measles virus has maintained a remarkably stable ecological relationship with man. The clinical disease is a characteristic syndrome of notable constancy and only moderate severity. Complications are infrequent, and, with adequate medical care, fatality is rare."

By augustine (not verified) on 15 Mar 2012 #permalink

@Chris

Is the measles vaccine effective for your son?

By augustine (not verified) on 15 Mar 2012 #permalink

@ Chris...the Ugh Troll linked to a paper that was presented at a public health meeting in 1966, that discusses mortality associated with measles.

Here's a picture of a Nigerian baby (circa late 1960s) who was not immunized and who required supportive medical care, because of measles:

http://www.vaccineinformation.org/photos/meascdc005a.jpg

"Late 1960s photograph shows a Nigerian mother and her child who was recovering from measles; note that the skin is sloughing on the child as he heals from his measles infection.
This child was among many who were cared for in camps set up during the CDC-led refugee relief effort during the Nigerian-Biafran war. Measles was a constant threat in these camps. Sloughing of the skin in recovering measles patients was often extensive, and resembles that of a burn victim. Due to their weakened state, children like the one shown here, need nursing care to avoid subsequent infections."

-Source: Immunize.org

And my point is that the anti-vax folks keep thinking that mortality is what is important, when it is not. The incidence is what determines if vaccination is effective, plus even if a person survives measles there is a not minimal chance of permanent injury.

Hence, the reason I insist that they do not mention mortality.

Lilady of propaganda

Here's a picture of a Nigerian baby (circa late 1960s) who was not immunized and who required supportive medical care, because of measles:

Did that kid live in a mud hut(like you sarcastically said you did)? What was his nutrition like? Did he have plumbing or clean drinking water?

Here's a picture of measles vaccine damage. He didn't recover.

http://www.dailymail.co.uk/news/article-1307095/Family-win-18-year-figh…

By augustine (not verified) on 15 Mar 2012 #permalink

Pegasus: Here's another link to an outbreak of measles in Minneapolis, last year:

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6013a6.htm

Put your "thinking cap" on and tell us why the index case and subsequent cases were not immunized against measles.

-Odd, isn't it, that the Somali community in Hennepin County "opted out" of the MMR jab?

-Which disgraced doctor traveled from his home in Austin Texas to Minneapolis two times just before the measles outbreak to discuss the "MMR Vaccine-Autism Link".

-Which disgraced doctor traveled from his home in Austin Texas to Minneapolis a third time, during the measles outbreak, to meet with Somali parents who "opted out" of the MMR jab?

-Did public health officials lie about the seriousness (morbidity), of the outbreak that resulted in hospitalizations of kids infected with measles?

Augustine, the reason nobody ever talks to you is because you have no understanding of the concepts of "evidence", "risk vs. benefit", or "maturity". Until you start acting your age, you will not be treated as an adult.

By Gray Falcon (not verified) on 15 Mar 2012 #permalink

How many people's lives are saved, or dramatically improved by pharmaceutical drugs? Be sure to include anticoagulants, diuretics, digoxin, antibiotics, antiretrovirals, immunosuppressants, thyroxine, insulin, non-steroidal anti-inflammatories and chemotherapy drugs for cancer.

Or statins, or anti-depressants, anti-psychotics, for starters. Just saying.

By stuv.myopenid.com (not verified) on 15 Mar 2012 #permalink

For centuries the measles virus has maintained a remarkably stable ecological relationship with man. The clinical disease is a characteristic syndrome of notable constancy and only moderate severity.

This strikes me as a strong statement to make about a disease that a few centuries ago wasn't even a human pathogen.

Wikipedia has more on this "moderate severity" over "centuries":

In roughly the last 150 years, measles has been estimated to have killed about 200 million people worldwide. During the 1850s, measles killed a fifth of Hawaii's people. In 1875, measles killed over 40,000 Fijians, approximately one-third of the population. In the 19th century, the disease decimated the Andamanese population.

By herr doktor bimler (not verified) on 15 Mar 2012 #permalink

But Herr Dr Bimler, that was because none of them had flush toilets! It's a confirmed medical fact that diseases spread through the airborne route like measles are entirely eliminated by installation of toilets.

And, it's a "confirmed" medical "factoid" that improved sanitation (flush toilets, pure water) are responsible for the dramatic decrease in all vaccine-preventable diseases...even childhood diseases that are transmitted through the airborne/droplet route.

Another "confirmed" medical "factoid" is that improved sanitation is responsible for the dramatic decrease in vertical and horizontal transmissions of the Hepatitis B virus to newborns and young children.

Aren't flush toilets wonderful?

And it's the wrong question. It could be shown that arsenic is effective against a particular disease. The question is "is arsenic effective? Does the risk of arsenic outweigh the projected benefit of arsenic?"

The clinical question is "Does one need arsenic?"
That is debatable.

If arsenic was effective against some condition, yeah, one would need arsenic. By the way, arsenic is present in the human body in trace amounts anyway.

By dedicated lurker (not verified) on 15 Mar 2012 #permalink

If arsenic was effective against some condition, yeah, one would need arsenic.

Just like a naive ideologue. Never question necessity or safety. This is called a lack of critical thinking.

You're a good minion.

By augustine (not verified) on 15 Mar 2012 #permalink

Augistine said:
"And it's the wrong question. It could be shown that arsenic is effective against a particular disease. The question is "is arsenic effective? Does the risk of arsenic outweigh the projected benefit of arsenic?"
The clinical question is "Does one need arsenic?"
Hey Augustine did you know that arsenic compounds are used. It one of the treatments for African Trypanosomiasis, also know as african sleeping sickness. In cases you don't know that's caused by Trypanosoma brucei, a flagellated Protozoa. While the the drugs do cause serious side effects, the disease is more dangerous, and the benefits outways risk by a lot. The disease without treatment almost always cause death. The death is a painfull one. I'll let you read about it yourself, and if you require evidence of this it's pretty easy to find.

"Pegasus, then explain very carefully your plan to prevent diphtheria, tetanus and pertussis in babies. Tell us exactly how the DTaP is more dangerous than those diseases, include how it is more toxic than tetanospasmin".

Your inane question above is typical of sceptic tactics. Pluck some ridiculous comparison (above) & then ask.."tell us exactly..." When the interloper refuses to waste his/her time, you then villify the person.It's interesting to note you use the pronoun "us" not "me".You surely are in a club ,& when someone opposes immunisation, you "club" them, metaphorically. "Show us..." How do you become one of "us".

Nutritional influences have been largely ignored by modern medicine in infectious disease. The nutritional status of the host is critical in permitting or preventing viral & bacterial infections & nutritional inadequacies in the host allow the modification of viruses into more virulent forms. ( J Am Coll Nutr, 2001; 20:5 is just one of a number of references I could cite).

Regarding the measles question, I don't know why the morbidity dropped, but I get the feeling you think you know ie vaccinations. Before I get excited by your belief, I would like to look at many other variables & co-morbidities during this time, plus other epidemiological evidence.It's a lot like justifying mammograms. The main criteria has been 'did breast cancer mortality decrease, stay the same or increase?' The real question should be(& slowly the med. est. is waking up)'did all-cause mortality decrease, stay the same or increase?

"Actually, crowded housing has *increased* since 1890, not decreased. And it's increased a lot, allowing the human population to grow from under 2 billion (we hit 2 billion in 1927) to an estimated 7 billion today. Urbanization has been a major part of that".

You're confusing houses with people. It was the people who were tightly housed in dwellings, that was the problem. This changed noticeably after WW1. There were more houses (urban) but less people in each house.

"You are not the first to come here and rant about Fosamax for reasons I do not really understand. Has Mercola or another CAM guru condemned it as an evil drug recently or something?"

Maybe they have, but so have a host of medical doctors, dentists & research scientists. In fact just a month ago my dentist commented how bad the bisphosphonates were, because he was the one seeing ONJ not the doctors, & he was appalled by the drug's use in healthy women.Although anecdotal, he said that many of his colleagues shared his concerns.
FYI, it is coming under attack because oteopenia is normal bone loss with age, just like skin losing collagen,& it does not often lead to osteoporosis at all, if the muscles are strengthened & a low-acid diet adopted.Sarcopenia & an acidic diet is the cause, not a lack of chemo! The PubMed references re fractures have been disputed widely from many sources ( www.betterbones.com; drfuhrman.com; drmcdougall.com; Cochrane Collaboration etc.

The drugs only really increase the density of cortical bone, not trabecula bone. And just because bone density is increased, does not mean that bone strength is increased, hence the atraumatic mid-femur fractures. A dense bone does not necessarily mean a strong bone, in fact it can mean a weaker, more brittle bone.And this is exactly what's happening.

And no, side effects are not uncommon. Why do you have to avoid lying down for at least 30 minutes after taking bisphosphonates? Because it irritates the esophogus. In the mid 90's when the drugs were released, they knew that esophagitis was a side effect. Now, they have upgraded the side effect to esophogeal cancer, because the drug's effects long term are very different, & more serious, than the early studies revealed. Atrial fibrillation is another. These major illnesses are certainly not common, but they are sometimes fatal. Less life-threatening but much more common side effects are esophogitis & incapacitating bone pain.

These chemo drugs were originally indicated for serious bone conditions like Pagets disease & osteosarcoma, & that was fine, but of course the drug companies realised that more money could be made by widening the market to include healthy women (read Selling Sickness by Moynihan). And many of their advocates were doctors on the drug companies payroll.

I do think you have missd something, & recommend you look up the websites mentioned.

To be honest, the person on this thread that was justifying big pharma's drugs & minimising the damage does sound like a great PR man for the drug industry.

And wasn't it Dr Marcia Angell (20 years as editor of the NEJM)who said in her book that the medical profession had become subservient (their valet or handmaiden, I think was her term) to bigpharma.In other words, doing the bidding for the drug companies, what a freakin' disgrace.

You cannot get a more scathing indictment of the medical profession than that. Selling out to bigpharma, OMG! And that criticism from a medico herself.

Modern medicine is great for a few things, but bloody dangerous for most things.Consumer, beware.

"How many people's lives are saved, or dramatically improved by pharmaceutical drugs? Be sure to include anticoagulants, diuretics, digoxin, antibiotics, antiretrovirals, immunosuppressants, thyroxine, insulin, non-steroidal anti-inflammatories and chemotherapy drugs for cancer. They are just the tip of the iceberg yet anticoagulant drugs alone save hundreds of thousands of lives every year"

Well that depends on who you talk to. If you talk to people like Drs Fuhrman, McDougall, Ornish, Esselstyn, Diehl,Gordon,Esser, Welch,Ritchie, Klaper et al they will all say that the mortality & morbidity accompanying the present unnecessary polypharmacy approach taught to doctors is unacceptably high. Most of these guys use nutrition instead of drugs, but this is not taught at medical school. Ask any of them where they learnt the finer points of nutrition as a major intervention in most chronic diseases & they will in unison say after they left medical school, & not at CPD Courses!

The doctors I know are absolutely clueless about interventional nutrition, apart from the archaic macro-calorie approach to weight loss & a little tinkering with fat levels to try & poke around LDL's.

Why is it that Esselstyn has written a book on reversing heart disease using mainly nutrition (with statins used in the occasional high-risk patients, but not routinely used in general)with phenomenal results, yet no doctors here have ever heard of him. As he quotes one of his surgeon colleagues when asked why he doesn't use nutrition to obviate the need for surgery in his patients: "I earn $5 million a year from surgical proceedures, that's why?"

Abba sang about it in the 70's: money, money, money....

There is no question that drugs can sometimes save lives. But when the medical profession is largely controlled by the drug companies, who are controlled by their directors, who are controlled by their shareholders, then truth about the actual casualties is never accurately reported.It's just not good for business.

While the the drugs do cause serious side effects, the disease is more dangerous, and the benefits outways risk by a lot.

Unbelievable. If you guys can convince yourself to say the words " the benefits outway the risk" you can rationalize ANY medical procedure on any person even if you have to get the government involved to force it.

Do you need arsenic, Matt F?
Then how do you know if my children needs an MMR vaccine?
They don't!

By augustine (not verified) on 16 Mar 2012 #permalink

Pegasus, so you can't or won't answer my questions?

So I looked at your reference:
J Am Coll Nutr. 2001 Feb;20(1):5-19.
Types of dietary fat and risk of coronary heart disease: a critical review.

Now how exactly does dietary fat protect an infant from pertussis? I see many who claim a perfect diet will keep kids safe from disease, but this the first time that there was a claim that coronary heart disease (usually a disease of old age) has been considered the same as pertussis.

So are you suggesting that instead of breast milk, infants should get fish? Or does the mother eat the fish and plant based fats to protect a child from pertussis.

Oh, do educate us on to protect kids from pertussis, diphtheria and tetanus using only diet!

And you really did not know about the incidence rates of measles? And since you know what the answer should be, you refuse to answer with some hand waving about something else.

You are very amusing Pegasus, and not in a good way.

Unbelievable. If you guys can convince yourself to say the words " the benefits outway the risk" you can rationalize ANY medical procedure on any person even if you have to get the government involved to force it.

So if a procedure has any potential for harm whatsoever, it shouldn't be done? If that's the case you must never do anything ever.

By dedicated lurker (not verified) on 16 Mar 2012 #permalink

dedicated lurker:

So if a procedure has any potential for harm whatsoever, it shouldn't be done?

I recently finished reading Breakthrough: Elizabeth Hughes, the Discovery of Insulin, and the Making of a Medical Miracle. When insulin was first being used for diabetes, some died from getting too much as it was difficult to create supplies with consistent effectiveness and to balance with the patient's own metabolism.

So in Pegasus' perfect world those children with Type 1 Diabetes would just have to die. Some did survive for a while on a very restrictive diet, but sometimes they actually starved (the diet was as low as 500 Calories). So even that diet would not met Pegasus' demands for 100% risk free criteria.

And to add: I would like to see more substance to Pegasus' ranting. I see lots of words, but nothing to support her/his statements (like what mammograms have to do with measles morbidity statistics). Perhaps this is a person who likes to bloviate for no particular reason other to feel the keyboard go clickity-click.

So if a procedure has any potential for harm whatsoever, it shouldn't be done?

I didn't say that.

By augustine (not verified) on 16 Mar 2012 #permalink

Dear Insolence visitor,

So as to give members of the scientific and autism commmunities a better sense of how Slapp suits can be used to harrass and intimidate journalists and media organisations, I have posted a photograph of the response from us necessary to deal with Andrew Wakefield's latest vexatious litigation.

He will get his day in court, but you can imagine the burden it puts on us in terms of time, energy and, of course, the extraordinary cost.

http://briandeer.com/solved/slapp-introduction.htm

Pegasus,
I wrote:

You are not the first to come here and rant about Fosamax for reasons I do not really understand. Has Mercola or another CAM guru condemned it as an evil drug recently or something?

You replied:

Maybe they have, but so have a host of medical doctors, dentists & research scientists. In fact just a month ago my dentist commented how bad the bisphosphonates were, because he was the one seeing ONJ not the doctors, & he was appalled by the drug's use in healthy women.Although anecdotal, he said that many of his colleagues shared his concerns.

Sorry, I don't believe your dentist sees enough people to accurately pick up a possible side effect that is so rare even large clinical trials of thousands of people have failed to reliably demonstrate a connection. Where is this "host of medical doctors, dentists & research scientists" anyway?

FYI, it is coming under attack because oteopenia is normal bone loss with age, just like skin losing collagen,& it does not often lead to osteoporosis at all,

Do you have any evidence for this extraordinary statement that osteopenia "does not often lead to osteoporosis at all?"

if the muscles are strengthened & a low-acid diet adopted.Sarcopenia & an acidic diet is the cause, not a lack of chemo!

Please, not this nonsense about an acidic diet and bone health again. It's not true! High animal protein (so-called "acidic") diets increase calcium absorption and excretion. Some have assumed that the increased urinary excretion means that an "acidic" diet dissolves calcium out of the bones and excretes it in urine. It doesn't. Calcium isotope studies have proved this beyond all reasonable doubt, as have epidemiological studies that find a link between low protein diets and both low bone density and fracture risk, the opposite of what the "acid diet" hypothesis would predict.

The PubMed references re fractures have been disputed widely from many sources (www.betterbones.com; drfuhrman.com; drmcdougall.com; Cochrane Collaboration etc.

Sorry, I don't consider those sources to be at all reliable. The betterbones.com website has an "Alkalize for Life" link on it which immediately tells me it is a quack site - it's run by nutritionist and medical anthropologist Dr. Susan E. Brown. Why would I think she knows better than the experts when it's not even her field of study? As for Drs. Fuhrman and McDougall, if that's where you are getting your information from it explains a lot. What about Cochrane? You might take a look at this article about bisphosphonates that takes a careful look at the evidence and concludes that bisphosphonates are both safe and effective.

The drugs only really increase the density of cortical bone, not trabecula bone. And just because bone density is increased, does not mean that bone strength is increased, hence the atraumatic mid-femur fractures. A dense bone does not necessarily mean a strong bone, in fact it can mean a weaker, more brittle bone.And this is exactly what's happening.

So how do you explain the dramatic reduction in fractures produced by these drugs? You are suggesting that alendronate actually reduces bone strength, yet the evidence shows it reduces both primary and secondary fractures by about 50%. That makes no sense at all.

And no, side effects are not uncommon.

I based my assertion on a review study that looked at several clinical trials comparing alendronate with placebo and with other treatments. A Cochrane review concluded, "For adverse events, we found no statistically signiï¬cant differences in any included study." What do you base your assertion on?

Why do you have to avoid lying down for at least 30 minutes after taking bisphosphonates? Because it irritates the esophogus.

It doesn't irritate the esophagus if you avoid lying down for 30 minutes after taking it. Not lying down for half an hour doesn't seem too onerous to me.

In the mid 90's when the drugs were released, they knew that esophagitis was a side effect. Now, they have upgraded the side effect to esophogeal cancer, because the drug's effects long term are very different, & more serious, than the early studies revealed.

A Cochrane review found no difference in adverse events between 5 years or 10 years on the drug. Some cases of esophageal cancer have been reported, but there has been no links reported in any clinical trials, so we don't yet know if there is a link or not, and if there is one it is very rare.

Atrial fibrillation is another. These major illnesses are certainly not common, but they are sometimes fatal.

They are so rare we don't even know if they are caused by alendronate. In contrast there are 2 million osteoporotic fractures in the US every year and alendronate reduces the risk of these fractures by 50%. Remember many fractures have a very high mortality in elderly people.

Less life-threatening but much more common side effects are esophogitis & incapacitating bone pain.

Here's Cochrane again on alendronate:

In general, the reported events were similar between alendronate and placebo. In particular, there were seven studies reporting âany upper gastrointestinal eventsâ resulting in an overall RR 1.03 (95% CI 0.98 to 1.08) and two studies reporting âesophageal ulcerâ, resulting in an overall RR 1.16 (95% CI 0.39 to 3.45).

Notice these small increases are not statistically significant and they don't even mention bone pain.

These chemo drugs were originally indicated for serious bone conditions like Pagets disease & osteosarcoma, & that was fine, but of course the drug companies realised that more money could be made by widening the market to include healthy women (read Selling Sickness by Moynihan). And many of their advocates were doctors on the drug companies payroll.

So how did they manage to manipulate the data to make it look as if alendronate reduces primary fractures by 50% in osteopenic women?

I do think you have missd something, & recommend you look up the websites mentioned.

I recommend you avoid websites that have a "Visit Our Store" button and stick to articles from peer reviewed journals.

To be honest, the person on this thread that was justifying big pharma's drugs & minimising the damage does sound like a great PR man for the drug industry.

I'm afraid you sound to me like a gullible idiot who has bought into some unscientific nonsense designed to persuade you to buy someone's product.

And wasn't it Dr Marcia Angell (20 years as editor of the NEJM)who said in her book that the medical profession had become subservient (their valet or handmaiden, I think was her term) to bigpharma.In other words, doing the bidding for the drug companies, what a freakin' disgrace.

I think you will find she was referring to the FDA. I don't live in the USA, I live in the UK where the NHS is short of money and only uses drugs and treatments that are proven to be cost effective. Guess what? We use the same drugs, more or less, as in the US, including alendronate, though not for osteopenia, not because of side effects but because it is too expensive.

You cannot get a more scathing indictment of the medical profession than that. Selling out to bigpharma, OMG! And that criticism from a medico herself.

Except, OMG, it wasn't a scathing indictment of the medical profession at all.

Modern medicine is great for a few things, but bloody dangerous for most things.Consumer, beware.

It's so "bloody dangerous" life expectancy has been steadily increasing, infant mortality has fallen about as low as it can go, even disability-free lifespan is increasing and heart disease mortality in the UK has dropped by 50% in the past 8 years. That's sarcasm by the way.

By Krebiozen (not verified) on 16 Mar 2012 #permalink

Oops, I did not know who dedicated lurker was quoting. I mostly skimmed Pegasus' bloviating drivel, and noticed nothing of substance (ie: real evidence).

Augustine, the reason nobody ever talks to you is because you have no understanding of the concepts of "evidence", "risk vs. benefit", or "maturity".

Well, that, and "long since having been killfiled for general swinishness."

This will, I hope, be my last bit of verbiage on this OT subject.

Pegasus,

If you talk to people like Drs Fuhrman, McDougall, Ornish, Esselstyn, Diehl,Gordon,Esser, Welch,Ritchie, Klaper et al they will all say that the mortality & morbidity accompanying the present unnecessary polypharmacy approach taught to doctors is unacceptably high.

I know, I have read more of that sort of material than I care to remember. The problem is that they have little evidence to actually back up their claims that they have an alternative that will work in the real world. Their patients come to them because of their reputation and are highly motivated and willing to change their diet and lifestyle. My colleague who held a weekly lipid clinic in a poor part of London had to deal with people who were morbidly obese, who smoked and drank alcohol against medical advice, and despite warnings did not change their lifestyle. She prescribed statins and fibrates. What else could she have done?

Most of these guys use nutrition instead of drugs, but this is not taught at medical school. Ask any of them where they learnt the finer points of nutrition as a major intervention in most chronic diseases & they will in unison say after they left medical school, & not at CPD Courses!

Perhaps that because "the finer points of nutrition" are not based on any evidence?

The doctors I know are absolutely clueless about interventional nutrition, apart from the archaic macro-calorie approach to weight loss & a little tinkering with fat levels to try & poke around LDL's.

As has been stated many times before, the best advice on nutrition is "Eat, not too much, mostly plants". Anything more than that is usually designed to sell you something.

Why is it that Esselstyn has written a book on reversing heart disease using mainly nutrition (with statins used in the occasional high-risk patients, but not routinely used in general)with phenomenal results, yet no doctors here have ever heard of him.

I have heard of him, but he hasn't published much, and what he has published has been criticised. He is in favor of a radical vegan diet which will lead to weight loss, which is probably the key to any success he has had, though less than 50% of his patients managed to stick with his regimen, which isn't great compliance, and they took statins. Color me unimpressed.

As he quotes one of his surgeon colleagues when asked why he doesn't use nutrition to obviate the need for surgery in his patients: "I earn $5 million a year from surgical proceedures, that's why?"

He asked a surgeon why he doesn't use nutrition? The clue is in the title.

Abba sang about it in the 70's: money, money, money....

Yet surgeons in the UK don't get paid any more if they do more surgeries, and they still do coronary bypass surgery, and angioplasty instead of cooking their patient a tofuburger. How can this be?

There is no question that drugs can sometimes save lives.

Sometimes? What planet do you live on again? You should spend a bit of time working in a busy emergency room or an intensive treatment unit, or even an anticoag clinic, and them tell me that.

But when the medical profession is largely controlled by the drug companies, who are controlled by their directors, who are controlled by their shareholders, then truth about the actual casualties is never accurately reported.It's just not good for business.

The medical profession is controlled by the drug companies? How does that work exactly? And at what point are clinical trials of a drug manipulated? It's just that I have been involved in a couple of clinical trials, and I have never been able to figure that out. How are all the extra deaths covered up? Before or after blinding is removed? Clinical trials are monitored and serious adverse events have to be reported (in the UK, and I assume elsewhere), and if a drug does seem to be causing unexpected deaths it can and will be halted. This does happen not that infrequently, torcetrapib is just one example. What went wrong with the cover-up over torcetrapib? Why did Pfizer waste $800 million on the drug and the abandon it if it could simply have covered it all up?

By Krebiozen (not verified) on 16 Mar 2012 #permalink

I have posted a photograph of the response from us necessary to deal with Andrew Wakefield's latest vexatious litigation.

My book is bigger than your book, therefore I'm right and you're wrong.

By augustine (not verified) on 16 Mar 2012 #permalink

If you talk to people like Drs Fuhrman, McDougall, Ornish, Esselstyn, Diehl,Gordon,Esser, Welch,Ritchie, Klaper et al they will all say....

Ah, the inevitable litany of heroes.

Posted by: Emily

But with very few exceptions, like Ornish, McDougall, Fuhrman, Klaper, Esselstyn, Sultana, Siegel, Koumantakis, Esser, Barnard etc, doctors know very little about the body's innate capacity to heal itself.

It's a tediously unoriginal script you're reading from, Pegasus.

I have posted a photograph of the response from us necessary to deal with Andrew Wakefield's latest vexatious litigation.

One of the better demonstrations I've seen of why anti-SLAPP (and anti-other forms of frivolous harassing lawsuits) laws are important. If he can necessitate that much response with that little work, well, it gets really effective to do so.

Pegasus seems to have little or no real education how medicine (and medical research) is actually done. For every one drug that makes it to market, there are dozens, sometimes hundreds of others that never see the light of day - if the FDA was as corrupt as the woo-meisters would like to have you believe, then this ratio would be reversed.

I didn't say that.

So does a risk/benefit ratio ever come into factor? Because it's not about merely saying there is a beneficial ratio; there has to actually be one.

By dedicated lurker (not verified) on 16 Mar 2012 #permalink

Pegasus seems to have little or no real education how medicine (and medical research) is actually done. For every one drug that makes it to market, there are dozens, sometimes hundreds of others that never see the light of day - if the FDA was as corrupt as the woo-meisters would like to have you believe, then this ratio would be reversed.

The way I'd put it:

Big Pharma:
1. Get an idea.
2. Do extensive tests.
2a. If the tests result in failure, all the money spent goes down the drain. Oh well. That's the cost of doing research.
2b. If the tests result in success, then release it to the market and watch carefully for bad effects that the tests might not have caught.
3a. If a really harmful and statistically demonstrable side effect does show up, recall the drug or put in a strong notice for vulnerable populations not to use it.
3b. If nothing bad happens, profit!

This, incidentally, is pretty much the terms of trust with nearly any medical claim. Big Pharma doesn't get special treatment: We consider them more trustworthy because they're willing to jump through those hoops, not because Big Pharma is part of our identity, contrary to the false framing alties are so fond of.

Big Altie:

1. Get an idea.
2. Experiment directly on the market. In other words, make customers pay full price (or even more, if you're Burzynski) for the privilege of being experimental subjects for an unproven treatment.
3. If the consumers die, tell the skeptics it's the patients' fault for not believing hard enough. Let the buyer beware.
4. Profit!

The fact that many wannabe medical providers operate under this reckless model is why we don't trust them. The fact that we don't trust them is why they effectively allied under the big tent of "alternative medicine": Artificially dividing medical claims into black and white camps allegedly playing out a melodrama is an effective marketing scheme for drawing in gullible people.

Narad:

It's a tediously unoriginal script you're reading from, Pegasus.

I'm wondering if we are not seeing the return of Emily, or her clone.

I find it fascinating that if we all adhered to a perfect diet then no one will ever get pertussis, diphtheria, measles or other infectious disease.

It's a tediously unoriginal script you're reading from, Pegasus.

Actual name-switching and sock-puppetry, or just cut-&-paste trolling?

By herr doktor bimler (not verified) on 16 Mar 2012 #permalink

I could spend all day countering the "drug em to fix em" mentality of you sceptics, but I have more important things to do.

I find it very amusing that if you criticise medicine & you are not a medic,perhaps you're even a naturopath or chiropractor or whatever, then you are automatically disqualified because you are a quack who is unable to read.

If you happen to be a doctor, like Professor Richard Ablin, the inventor of the PSA test, & you happen to caustically criticise the medical profession: "the proliferation of screening reached a fervor which would not disgrace a medieval inquisition" Cancer Epidemiology, Biomearkers & Prevention: March 2012, then you are labelled from the dark side, & not to be trusted. Ablin also stated that the PSA test "was no better than a coin toss" & " the results of PSA screeing had resulted in a tragedy of overdiagnosis & overtreatment in excess of million men in the USA".

I suppose he has also lost the ability to read, like the unqualified quacks you deride.

Then we have the BMJ headline in 2002 : Who owns the FDA. The People or the Drug Companies?

And don't tell me that this proves that the machine is working. It is fundamentally flawed, simply because Marcia Engell hit the nail right on the head. Yes, the FDA (you were right, it was the FDA) is the servant of the drug companies. The BMJ was right with their pointed question.

The medical profession has swamped its great contribution to our comfort by selling out to bigpharma.

The reason the doctors I mentioned get such great results is because they use drugs as a last resort not a first line & they understand the role of nutrition in the prevention & treatment of disease. Even if this has not been proven by rct's, who gives a rat's armpit?

Don't worry about whether Fuhrman, McDougall, Ornish, Klaper et al has peer-reviewed evidence, just have a look at their results, for God's sake!

Sceptics,drug-lovers/nature deniers that you are, just open your eyes to what is going on with the patient results at these clinics. Don't wait for rct's. It might be too late for you.

So many words, so little substance. And absolutely nothing that is on topic.

Be fair, Chris. Gish galloping is the only exercise some people get.

By herr doktor bimler (not verified) on 16 Mar 2012 #permalink

Oh, great. I am now remembering the person in the library who was furiously and loudly pounding the keyboard at the computer station. Who knows? It could have been Pegasus.

augustine this what you said
"Unbelievable. If you guys can convince yourself to say the words " the benefits outway the risk" you can rationalize ANY medical procedure on any person even if you have to get the government involved to force"

Though you might have not have said those exact words you were definitely implying what dedicated lurker said. If not then I have no idea of what you mean because almost everything we do on a daily basis, whether it be medical or a daily routine carries some sort of risk. If you doubt it ask anybody whose had how miserable they were.
Though you are a troll I will actually answer you. No, I do not need arsenic I have not acquired Trypanosomiasis, nor will I probably ever acquire it because I will probably never find myself in sub-Saharan Africa but there are millions who need it because it is not a uncommon disease for several sub-Saharan countries.

Children require the MMR because all of those disease can be deadly the reason that you do not see that often in the US is the testimony to the effectiveness of the vaccine, and if people like you are successful in you campaign of misinformation these disease will make a comeback as they have already, but in a much larger way

In my comment #288 the sentence "If you doubt it ask anybody whose had how miserable they were." Should be the the second sentence of the third paragraph. Stupid typing mishap.

Pegasus:

Why did you change your handle from "Emily"?

By OccamsLaser (not verified) on 16 Mar 2012 #permalink

Pegasus is sounding like Emily... The same reliance on nutrition and 'natural hygiene', the same reliance on books instead of papers and a few 'authority' doctors, the same continued attempt to suggest SBM doesn't include nutrition and other concepts in their training, the ignorance of history and anti-vax stance, the Big Pharma/money gambit, the clause of SBM being useful for 'some things', the same idealistic view of the world...

Actually that sounds like most CAM proponents anyway.

... Er, nevermind, just saw #277. Glad to know Narad thought the same.

@ Beamup ( # 278):

I agree: he wasn't able to show that he was correct by *data*, by *replication*, by *testimony* to the GMC or on *appeal* so he needs to *barrate* his critics. Anti-vaxx groups, like alt med providers, have an overly-friendly relationship with legal professionals which is achingly apparent if you look closely at the 'VIP' lists at their many websites. The fate and fortunes of AJW seem bound up with legal manoeuvring starting very early in the game. If you live by the sword, don't be surprised if one day it's turned against you. Hopefully, we're looking at *le dernier cri* or the *last gasp*- if you pardon my translation.

By Denice Walter (not verified) on 16 Mar 2012 #permalink

Though you might have not have said those exact words you were definitely implying what dedicated lurker said. If not then I have no idea of what you mean because almost everything we do on a daily basis, whether it be medical or a daily routine carries some sort of risk. If you doubt it ask anybody whose had how miserable they were.

Do you suggest we live by some sort or David Gorski/Harriet Hall algorithm?

Though you are a troll I will actually answer you. No, I do not need arsenic I have not acquired Trypanosomiasis, nor will I probably ever acquire it because I will probably never find myself in sub-Saharan Africa but there are millions who need it because it is not a uncommon disease for several sub-Saharan countries.

But there are some die hards on here that can convince you that you ARE at risk. It's only a plane ride a way.The risk is homogenous. We all need it, Or we'll die or be maimed.

Children require the MMR because all of those disease can be deadly the reason that you do not see that often in the US is the testimony to the effectiveness of the vaccine, and if people like you are successful in you campaign of misinformation these disease will make a comeback as they have already, but in a much larger way

Oh foolish child, Can you tell me the risk of measles being dangerous to my child? You can't? Yet you want to convince me that my child needs it? Is Measles more deadly than the arsenic "required" Trypanosomiasis?

By augustine (not verified) on 16 Mar 2012 #permalink

Do you suggest we live by some sort or David Gorski/Harriet Hall algorithm?

By dedicated lurker (not verified) on 16 Mar 2012 #permalink

Is Measles more deadly than the arsenic "required" Trypanosomiasis?

Which Trypanosomiasis? African or Chagas disease? Both can't be spread by human to human contact, by the way. You have to be bitten by an infected insect, much like the bubonic plague.

Can you tell me the risk of measles being dangerous to my child?

How old is the child? Where do they live? What is their past medical history?

Oh, and what's the risk of the MMR being dangerous to your child?

By dedicated lurker (not verified) on 16 Mar 2012 #permalink

Dedicated lurker, though it doesn't matter to Augustine as he obviously doesn't know what the two diseases are, or understand vector borne diseases, i did say African Sleeping Skickness.I did not mention Chaga's Disease since it is hard to treat a latent infection and most people live years with disease, as I am sure you know. While the one caused by T. brucei's two human subspecies are acute disease. Though if you live on the border of US and Mexico you are at risk, so to Augustine there is a chance for us citizens to get a trypanosomiasis, though I can not remember what is used for treatment.

Keep plugging away Augustine, & remember that the majority is often wrong, just as the majority is wrong about vaccinations.You are doing well against these pro-drugging, nature-quarantined clubbers.

They still promote herd immunity but when you ask them to supply scientific evidence of its veracity, they get personal & call you quack, disease-vector, woo-meister etc.I'm still waiting for one person to prove to me that herd immunity is nothing more than woo in sheep's clothing.

Herd immunity is total BS & is one reason among many why my wife & I have not vaccinated our children, & never will. Jay Gordon, Al Sears, Barbara Loe Fisher, Meryl Dorey, Jo Mercola, Missy Fluegge, Jenny McCarthy, Jeffry John Aufderheide, David Ritchie, Mark Donohue et al are all fighting the good fight. Health freedom. They all might have different views on health but they stand as one against the "do as I say cause I know what's good for you & your child" brigade.

Modern medicine overall is slowly imploding, as much from self-harm ( see Professor Ablin, Dr Douglas Graham, prof Rob. Mendelson,Dr Fuhrman, Dr McDougall, Dr Ornish, Dr Esselstyn, Marcia Engel et al exposing the non-science BS & the harm that ensues from within), as from gradual public distrust & from increasing doctor dissatisfaction with their own band-aid suppressive pseudo-science propaganda. These whisleblowers & the flood of others will increasingly erode public trust, & not before time.

Then we have those who shoot themselves in the foot, like Dr John Dwyer from Australia who has organised the group 'Friends of Science'in trying to kick altmed out of University courses. Every time he talks he embarrasses himself & more & more people just see through him as a bigot. He does his cause more harm than good. Another internal imploder.He needs vaccinating against foot-in-mouth disease.

Anyway keep up the fight for health freedom Augustine, even though you're outnumbered. And remember, you can lead a camel to water, but getting the sceptics to see past their pseudo-science is like getting the same camel through the eye of a measles needle. Anyone for camel milk?

Which Trypanosomiasis? African or Chagas disease?

the one that you say arsenic is required for.

How old is the child?

Does it matter?

Where do they live?

Why? Is there a difference in risk?

What is their past medical history?

Again, Why? Is the risk different? how much difference?

Oh, and what's the risk of the MMR being dangerous to your child?

In a relative percentage term what's the risk of my child having a convulsive febrile seizure with the MMR as opposed to not having it at all? What if my child is named Hanah Poling but you don't know that? How do you know what her risk is? Do you accept any personal responsibility? No you don't. Will, orac,lilady(in her local county health dept.), Chris with no resposibility, or any other blogger? Certainly not. They'll just haphazardly, irresponsibly blog away.

Does that mean that it affects the brain or is it just peripheral covulsive spasms?

How do you know this? because ORac told you so? James Randi perhaps?

By augustine (not verified) on 16 Mar 2012 #permalink

Dawns on me that Pegasus is the poster formerly known as Emily. If the shoe fitz...

Pegasus, you should disclose your financial interest in the therapies you promote. You know, clinic income, seminars, CDs/DVDs, that sort of thing.

By OccamsLaser (not verified) on 17 Mar 2012 #permalink

No, Pegasus, if you are claiming that herd immunity is "woo in sheeps clothing," it's your job to prove it. You don't get to sit around and wait for the people you disagree with to "prove" things they never said.

"Health freedom"? Do you want the right to get a job in a restaurant and not wash your hands before handling food? Or to feed your children large quantities of laudanum if they're crying at night?

You may have the right to kill yourself. You don't have the right to kill strangers, or your underage children.

They still promote herd immunity but when you ask them to supply scientific evidence of its veracity, they get personal & call you quack, disease-vector, woo-meister etc.I'm still waiting for one person to prove to me that herd immunity is nothing more than woo in sheep's clothing.

Sure, that's easy. Herd immunity is actually a mathematical consequence of individuals developing resistance/immunity, so the proof is easy to do. Let's postulate a disease called DF, dandelion fever, that is transmissible between humans and which people are 90% likely to come down with if they are exposed to it. There is also a preventative treatment called MDR, magic dandelion root, which reduces the chances of developing DF, if exposed to it, down to 5%.

Now, the disease spreads through contact between humans. This means that each act of transmission requires three things: 1) a person from group C, those who already have the disease and are contagious; 2) a person from group U, those who have not yet had the disease; and 3) an incident of contact between the two people.

If no measures at all are taken to intervene in the course of the disease, then it will take the following general course:
* group C will start out small; group U will start out very large; most contacts between people will be U-U, not C-U, and transmission will go slowly (from the standpoint of the general population).
* group C gets larger; group U is still very large; there are a lot of C-U contacts and 90% of them result in the U party moving to group C.
* C-U contacts actually start decreasing, for two reasons: group U is diminishing in size, and after a while, C people are no longer contagious, and they enter group A (already had the disease.) Contacts can be A-A, A-C, A-U, C-C, C-U, or U-U, and the onlycontact type that can spread the disease is C-U. The first four contact types are getting more frequent, and the last two getting less frequent; the spread of the disease is slowing down, and sooner or later it "burns out," at least for the particular time and place.

Now, what happens if 80% of the population get the MDR treatment?
* group C starts out small; group U starts out very large; most contacts will be U-U, and of the C-U contacts that do occur, very few of them will transmit the disease. 20% of those contacts will give a 90% risk of moving the U party to group C, but 80% of contacts will give only a 5% risk. (.20 x .90) + (.80 x .05) = .22%. That means the disease is spreading only about one-quarter as fast as it was before, now that only 22% rather than 90% of C-U contacts result in transmission of the disease.
* group C is gaining people only a quarter as fast, but it's still losing people to group A at the same rate. That means that a lot of U people who otherwise would have joined group C now simply stay in group U, because three-quarters of what would have been contacts with group C are now contacts with group U instead - and pretty soon, the population of group C is dropping so low that C-U contacts become rare, and the disease burns out.

Now, Pegasus, take careful note of something about the analysis we just walked through: not a single piece of it is conditional upon the MDR treatment being a vaccine. All we specified is that it was a treatment which reduced the chances of an individual developing a disease when exposed to it by a given amount. Any treatment which achieved that preventative effect would create herd immunity when used by a sufficient percentage of the population - whether it's a vaccine, an herb (magic dandelion root), a special diet, it doesn't matter. Which means that people who say "I don't believe in herd immunity because I don't believe in Big Pharma drugs; I believe in the power of good nutrition instead" have just told us that they don't even understand what herd immunity is. It tells us that they probably reached their opinion, not by researching the issue, understanding the issue, weighing the evidence, and coming to a conclusion, but by saying "I'll assume whatever mainstream science says is wrong and everything my favorite alt-med figures say is right."

Now, Pegasus, we've noticed that you have a little ... problem with changing the subject rather than admitting your talking points have been fully refuted. So what's going to happen is that we are going to interpret change of subject as concession: if your next two comments (on this thread or any other) do not address the fact that herd immunity has just been proven to you mathematically, we will say "Pegasus has admitted that herd immunity exists and protects people against disease" from now on. Sorry, but it's something you've brought on yourself.

By Antaeus Feldspar (not verified) on 17 Mar 2012 #permalink

You may have the right to kill yourself. You don't have the right to kill strangers, or your underage children.

You are exactly right. You, or the government, does not have the right to kill strangers or children with their vaccines.

"It wasn't OUR bullet that injured your child". It was all of those OTHER bullets" seems to be the medical profession's defense.

By augustine (not verified) on 17 Mar 2012 #permalink

Pegasus,

They still promote herd immunity but when you ask them to supply scientific evidence of its veracity, they get personal & call you quack, disease-vector, woo-meister etc.I'm still waiting for one person to prove to me that herd immunity is nothing more than woo in sheep's clothing.

Someone who is immune to a disease cannot catch it and spread it to others. If lots of people in a population are immune to disease, a person in that population who does catch that disease is less likely to come into contact with a non-immune person and give them the disease. That's herd immunity. What bit of it is "woo in sheep's clothing"? What bit of it do you deny? Or do you simply not understand how immunity works, like some of the trolls here?

I consider someone who denies the existence of herd immunity as being as ignorant as someone who seriously believes in a flat earth or in creationism. The overwhelming evidence supports the existence of herd immunity, and unless you don't believe in antibodies, or acquired immunity (which would be nuts), I don't see how you could possibly deny it.

By Krebiozen (not verified) on 17 Mar 2012 #permalink

I see she is still pounding the keyboard with idiotic ferocity, pushing out lots of words and absolutely no substance. Especially with this bit of illiterate brain dropping:

Jay Gordon, Al Sears, Barbara Loe Fisher, Meryl Dorey, Jo Mercola, Missy Fluegge, Jenny McCarthy, Jeffry John Aufderheide, David Ritchie, Mark Donohue et al are all fighting the good fight. Health freedom.

Health Freedom must be defined as "Belief instead of reality."

the one that you say arsenic is required for.

African then. Arsenic is a treatment, however, not a preventative.

Does it matter?

Yes, for a variety of reasons.

Why? Is there a difference in risk?

Yes. If you live in Antarctica or the Sahara your risk is low. If you live in a place with a recent outbreak the risk is much higher.

Again, Why? Is the risk different? how much difference?

Of course. If the child has a chronic lung condition, or a primary immune deficiency, or a mitochondrial condition, or a condition that requires periodic use of steroids, the child is at greater risk. How much of said risk of course depends on the condition in question.

In a relative percentage term what's the risk of my child having a convulsive febrile seizure with the MMR as opposed to not having it at all?

Not at all ever? Not much. Febrile seizures are common in small children, and are associated with any high fever, vaccine or no vaccine.

What if my child is named Hanah Poling but you don't know that?

Then even if she never got the MMR she would be at high risk for febrile seizures due to her underlying mitochondrial condition.

Do you accept any personal responsibility?

For what, exactly?

Does that mean that it affects the brain or is it just peripheral covulsive spasms?

The high fever that triggers the seizure is associated with misfiring electrical activity in the brain. The motor activity that is impaired is a result of that. Oh, and 99% of children who get febrile seizures will survive without permanant sequelae, just like you are so fond of saying about the measles.

How do you know this?

These little things called books, which I use for an activity commonly refered to as "reading."

By dedicated lurker (not verified) on 17 Mar 2012 #permalink

I hadn't heard of Dr. John Dyer and 'Friends of Science in Medicine'. Judging by Emily/Pegasus' insults I thought he and his group must be worth checking out, and he was. Thanks Emily/Pegasus!

Dyer is one of several doctors worldwide who are rooting out the unscientific nonsense, like homeopathy, iridology, reflexology, kinesiology, healing touch therapy, aromatherapy and âenergy medicineâ, that has crept into many universities. His work seems very similar to the admirable efforts of David Colquhoun, Edzard Ernst and Simon Singh to root out university courses in "pure gobbledygook" in the UK.

University administrators are often unaware of what idiocy has crept in through the back door in the guise of "bridging traditional knowledge with evidence based scientific medicine" and are often shocked when it is brought to their attention. Merely bringing what is being taught in their university to their attention is often enough to persuade them to take action.

Those of you who attend academic institutions where this sort of nonsense is taught might like to get hold of some particularly idiotic course material and send it to the university dean or equivalent. A covering letter simply asking if they are aware of what students are being taught in their name would be wise. Just a thought.

By Krebiozen (not verified) on 17 Mar 2012 #permalink

It's a tediously unoriginal script you're reading from, Pegasus.

Actual name-switching and sock-puppetry, or just cut-&-paste trolling?

Would "imitative archetype" be a contradiction in terms?

Jay Gordon, Al Sears, Barbara Loe Fisher, Meryl Dorey, Jo Mercola, Missy Fluegge, Jenny McCarthy, Jeffry John Aufderheide, David Ritchie, Mark Donohue et al are all fighting the good fight

Yes because when I want medical advice, I locate my local stripper/TV star/donations fraud/alt med 'energy' believer. When I want medical advice based in science and health freedom, I choose only those people who provide no evidence at all - why? Because of course, they confirm my biases and are just so much better than .... oh, I'm sorry you were going on about needing evidence for vaccines... I'm confused, do you want me to accept evidenced-only ideas, or non-evidenced ideas? You seem to want to do both...

Hey, you have another thing in common with Emily: you use the creationism tactics of attacking the science instead of providing your own and drop names like they were peer-reviewed papers.

Then we have those who shoot themselves in the foot, like Dr John Dwyer from Australia who has organised the group 'Friends of Science'in trying to kick altmed out of University courses. Every time he talks he embarrasses himself & more & more people just see through him as a bigot. He does his cause more harm than good. Another internal imploder.He needs vaccinating against foot-in-mouth disease.

Being an Aussie, I think it's a good thing. Universities promote plenty of CAM crap, and there are lots of little independent 'institutes' and 'colleges'. I go past 10-20 just on the way to work, most of them Chinese woo. These days I play 'spot the woo clinic' as there's so many I go past on my daily travels. It would be nice if there was more education based on proven ideas, rather than education based on unproven crap. Particularly when it comes to government-funded (ie. taxpayer funded) universities and colleges. It's about time scientists stood up to it and fought back, particularly as it affects allocation of resources for their own programs which are diverted to less scientific ones. I applaud their guts and willingness to stand up to their employers. How "bigot" gets into the conversation I don't know...

But hey, these guys threaten your potential income don't they? You being a practitioner, educator and all round 'pilot'. No wonder you don't like them.

PS. You can go on about 'health freedom' all you like, but we as a society tend to get annoyed when people get conned. There's a difference between being informed and making a choice, and being misinformed and making a choice. So now you get a little bit of Sid's ideas and start acting like regulation's a bad thing. We don't teach kids creationism in Australia (well, not strictly true depending on your local RE classes which are currently being lambasted too), why are we teaching university courses on homeopathy?

Tell us again about germ theory, or maybe let's talk about your issues with evolution... We've done the anti-vax dance already.

No Vicky it's your job to prove it because you're the one promoting the risky interventiion, not me. And part of your promotion/propaganda to the public is based on fear & coercion that if they don't get shot then they are endangering others because of supposed herd immunity. You have to prove it first, it's your theory, it's your intervention.

Hand washing in a restaurant is a poor analogy. If I want a job there I will comply with the employer's rules, end of story, whatever my views on hand-washing, germ theory etc. And I certainly don't have the right to kill, & you don't have the right to force medication upon anybody, & vaccines are medication which have the potential to main & kill.I have no objection to you getting vaccinated or your children, but then don't force me to do what you do, because of some theory (herd).

Antaeus - you seem to forget that disease is multi-factorial, even infectious disease. It does not work mathematically. Disease cannot be broken down & explained mathematically, there are too many variabls & unknowns. You have the host, you have the microbe & the interface between the two is constantly changing. It is not mathematically predictable, as that interface is different between individuals & different for each individual at different times depending on their state of health. I totally reject your explanation.

Krebiozen- you should know better than that. There have been cases where people, ostensibly "immune" (shown through antibody titres) have caught the disease. Antibodies are just one aspect of a complicated mechanism called the immune system. BTW even Professor Karen Phelps, former head of the Australian Medical Association in OZ, has vehemently disagreed with John Dwyer over his misguided attempts to bully the universities. She stated proudly that her clinic uses acupuncturists, herbal therapists, naturopaths as well as conventional medics. She has debated him on air & it's not a good look for old John. I suppose she must have lost her ability to read too, like all other quacks.

And noone has criticised the whisleblowers I mentioned- Dr Marcia Engell & Professor Richard Ablin, so I assume you agree with them. There is hope for common sense after all. I hear the implosion getting louder. Remember the motto: science today, nonsense tomorrow.

"Remember the motto: science today, nonsense tomorrow. "

You're giving us the nonsense today - will you be giving us the science tomorrow?

By the way, why does Orac let you post here. Do you think that you're effective in promoting your position but that Orac somehow doesn't realize that, or is Orac paying you to make anti-vaccine advocates look selfish and stupid?

@Pegasus - herd immunity was in place long before vaccines came around & yes, it can be expressed as a mathmatical equation. Again, try reading some medical textbooks for a change, your ignorance is showing....and your emperor has no clothes.

@Pegasus:

you seem to forget that disease is multi-factorial, even infectious disease. It does not work mathematically. Disease cannot be broken down & explained mathematically, there are too many variabls & unknowns.

Herd immunity is something that applies to, and happens at, the group level, so you don't need to predict any individual person's response to vaccines to predict its existence.

By Matthew Cline (not verified) on 17 Mar 2012 #permalink

@Pegasus
While you saying disease cannot be expressed by Mathamatics, refers probably just to herd immunity, shows how much science knowladge you lack, and means nothing we say will change you mind, you might want to look up a major aspect of public health known as epidemiology. It's all about statistics. You can look up incidence and prevalence, or any number of caculations that relate to disease.

Dedicated lurker

the one that you say arsenic is required for.

African then. Arsenic is a treatment, however, not a preventative.

Hence the problem with "preventative medicine" it's given to everyone and it's a crapshoot. The vast vast majority of people will not succumb to disease like chicken pox or measles but they are taught by fear that they will.

Yes, for a variety of reasons.

Don't be so specific.

Why? Is there a difference in risk?

Yes. If you live in Antarctica or the Sahara your risk is low. If you live in a place with a recent outbreak the risk is much higher.

Is it just where you live or what type of person lives there? Why doesn't EVERYONE who lives in a certain region get it and then die? What's the difference?

Again, Why? Is the risk different? how much difference?

Of course. If the child has a chronic lung condition, or a primary immune deficiency, or a mitochondrial condition, or a condition that requires periodic use of steroids, the child is at greater risk. How much of said risk of course depends on the condition in question.

The point of all of this is you don't know and there aren't any reliable pragmatic. In public health EVERYONE is treated as a number and they are considered the lowest of the low. The sickest of the sick. The worst of the worst. Of course it's all about the vague risk vs benefit that can't actually be quantified for any single individual.

In a relative percentage term what's the risk of my child having a convulsive febrile seizure with the MMR as opposed to not having it at all?

Not at all ever? Not much. Febrile seizures are common in small children, and are associated with any high fever, vaccine or no vaccine.

You're going to need a citation for that one. Peer reviewed. Showing unvaccinated children get convulsive febrile seizures at the same rate as children given MMR. There is plenty of peer review to suggest that you are wrong.

What if my child is named Hanah Poling but you don't know that?

Then even if she never got the MMR she would be at high risk for febrile seizures due to her underlying mitochondrial condition.

Are you playing the "she would have ended up with brain damage even if she didn't have the MMR vaccine" card?
That's pretty unscientific of you.

Do you accept any personal responsibility?

For what, exactly?

For vaccine damage and failure? Of course you don't. No skeptic would.

Does that mean that it affects the brain or is it just peripheral covulsive spasms?

The high fever that triggers the seizure is associated with misfiring electrical activity in the brain.

You must be a neurologist.LOL, Sorry I forgot. You're just dedicated to lurking.

The motor activity that is impaired is a result of that.

More specific neurology or just lurking again?

Oh, and 99% of children who get febrile seizures will survive without permanant sequelae, just like you are so fond of saying about the measles.

Now you're really lurking and getting away from mechanism of action of vaccine induced brain damage.

Oh, and BTW then why do so many parents use tylenol for fevers? Why exactly have they been scared to death about febrile seizures?

How do you know this?

These little things called books, which I use for an activity commonly refered to as "reading."

There's a book on Hannah Poling, Bailey Banks, and the thousands of others whom are medically induced vaccine brain damaged? There's a book that tells you how you can prove a negative? There's a book that can tell you my child will get a chickenpox,HPV, or measles infections and be permanently injured?

But I digress. The question is one of epistemology. Your answer "I read" is not sufficient.

By augustine (not verified) on 17 Mar 2012 #permalink

Herd immunity is not a "theory" that needs to be "proven". It's the simplest of simple arithmetic. If there's no such thing as herd immunity, then there's no such thing as a subcritical mass of plutonium, and any amount, no matter how small, will explode. The arithmetic is of exactly the same form. Pegasus, you're a moron.

By The Very Rever… (not verified) on 17 Mar 2012 #permalink

Herd immunity is not a "theory" that needs to be "proven". It's the simplest of simple arithmetic.

So show this simple arithmetic formula and where vaccine failure is accurately accounted, and the methods of which the accuracy is measured.

You could start with the Pertussis vaccine.

By augustine (not verified) on 17 Mar 2012 #permalink

There have been cases where people, ostensibly "immune" (shown through antibody titres) have caught the disease.

So what? I didn't mention antibody titers, I wrote "Someone who is immune to a disease cannot catch it and spread it to others." Most but not all people who contract measles, for example, are immune to measles afterwards, and don't get it again if re-exposed. Most, but not all, people who are vaccinated against measles are then immune. The mathematical model takes that into account, and it is effective at predicting that an outbreak of a specific disease will occur when immunity in a population falls below a specific level.

My son contracted pertussis as a baby and spent several weeks in the hospital because of an outbreak caused by a failure of herd immunity. In that case vaccination rates fell due to an unfounded vaccine scare and outbreaks occurred just as the mathematical model predicted. I suppose you would claim that the fall in vaccination rates and the subsequent increase in incidence and mortality was a coincidence.

By Krebiozen (not verified) on 17 Mar 2012 #permalink

Antaeus - you seem to forget that disease is multi-factorial, even infectious disease. It does not work mathematically. Disease cannot be broken down & explained mathematically, there are too many variabls & unknowns. You have the host, you have the microbe & the interface between the two is constantly changing. It is not mathematically predictable, as that interface is different between individuals & different for each individual at different times depending on their state of health. I totally reject your explanation.

Pegasus - Ever hear of the law of large numbers? Ever hear of Monte Carlo methods? I'm afraid your idea that being unpredictable in individual cases makes the spread of disease impossibly unpredictable at a population level is simply not true.

Do the numbers ever work out as neatly and roundly as they did in our example - 90% without preventative treatment, 5% with treatment? Of course not, but the principle of herd immunity is not dependent upon those numbers. Each person who contracts a disease is at the end of a long chain of person-to-person transmissions - Abel infects Betty, Betty infects Clara, Clara infects David, David infects Emily, and so on. The principle of herd immunity is that by giving preventative treatment to enough of the population, and thus making enough of those transmissions sufficiently unlikely to succeed, most of those chains will stop at earlier points, and people who would have been reached by those chains... now aren't. Pretending that the principle doesn't exist because disease is supposedly too unpredictable and "multi-factorial" is as foolish as saying "Well, no one can really know how any particular roulette spin is going to come out, so it makes sense for me to keep gambling every dollar I have!" You only need to know that the odds favor the house to know that continued gambling leads to greater and greater losses. And it doesn't take a genius to see that a contagious population which loses members faster than "successful" infections can replenish those numbers is a population that's going to burn itself out.

Not to mention that, since nothing about herd immunity is dependent upon the preventative treatment being vaccination, any alt-medders who say they don't believe in herd immunity are really saying "Yeah, all that stuff we tell you about how a vegan, GF/CF diet will make your immune system super-special awesome and you'll never get any of those nasty contagious diseases? Yeah, we don't really mean that. If our prevention measures actually worked, then a sufficient number of people practicing them would create a herd immunity effect in the population. But herd immunity doesn't exist, so therefore our product is bleh at best at doing what we claim it does."

By Antaeus Feldspar (not verified) on 17 Mar 2012 #permalink

The Very Irreverent Battleaxe of Knowledge: Germ theory & Herd immunity theory, are just what their name states: theories, & have been named as such in medical textbooks. You may be believe in your theories & I defend your right to that. I believe strongly in different theories.

I believe in Lord Rutherford's statement: that the only pure science is physics, all the rest is stamp collecting.

To call modern medicine a science is to denigrate the very term.

It is universally acknowledged that not all modern medical practices are science- based, even the most loyal sceptics would agree with that. So here's a question for all the clubbers:

What percentage of medical practice on any given day would not qualify as science-based medicine?

Pegasus, Lord Rutherford died over seventy years ago. Even physics has gone beyond pure absolutes. Ever hear of string theory and multiverse concepts?

You are looking even more silly.

Emily/Pegasus, it is usually advisable that when you have dug yourself in so deep that you should stop digging.

"My son contracted pertussis as a baby and spent several weeks in the hospital because of an outbreak caused by a failure of herd immunity. In that case vaccination rates fell due to an unfounded vaccine scare and outbreaks occurred just as the mathematical model predicted. I suppose you would claim that the fall in vaccination rates and the subsequent increase in incidence and mortality was a coincidence"

No one would know for sure. There have been vaccination rates fall in many areas ( my own area for eg) yet there have been no outbreaks of any infectious diseases. It. is. not. predictable.

Matt F: epidemiology studies population trends or associations, & not causation. That doesn't stop the vaccination proponents from laying blame on the unvaccinated when an outbreak does occur. How often do the puppeteers state for media fear-mongering purposes, all the while knowing what they say is pure conjecture: 'the outbreak was caused by unvaccinated children' (even if the rates of vaccination have been high). Are you saying vaccinated people can't spread the disease?

My son contracted pertussis as a baby and spent several weeks in the hospital because of an outbreak caused by a failure of herd immunity. In that case vaccination rates fell due to an unfounded vaccine scare and outbreaks occurred just as the mathematical model predicted.

That's a load of unscientific crock. I'm calling you out, Krebiozen and you're going to lose. Pertussis is already known to have a high failure rate. You blaming the conscientious unvaccinated can not be supported. I guarantee it. Your "mathematical model" is a failure! Why don't you produce it so it can be ripped to shreds? Not by the skeptics of course.

By augustine (not verified) on 17 Mar 2012 #permalink

Pegasus:

Of course disease works mathematically! The whole sodding Universe does.

All biology is chemistry, all chemistry is physics, all physics is maths. How else do you think supercomputers can simulate new drug molecules or predict how a disease spreads (which they can do with incredible accuracy)?

Maths. Computers know no other language.

And if you "don't believe in germ theory" (!), do try some raw chicken and let us know what happens...

Keep digging, Emily/Pegasus! Keep digging!

Pegasus:

"epidemiology studies population trends or associations, & not causation."

You must be kidding, or else you are clueless how an outbreak of a communicable disease is investigated. Do you honestly belief that media reports contain figures of new cases, without the input of the local and State health departments, whose trained epidemiologists actually investigate disease outbreaks?

Pegasus...care to comment on this MMWR article?

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6013a6.htm

Tell us how many of the cases were unimmunized, how many cases were laboratory confirmed and how many were epidemiologically linked to the index case.

Seeing that you are posting on this particular thread...which disgraced doctor "targeted" the Somali population in Hennepin County with his new "theory" of increased autism risk...following MMR immunization?

Pegasus:
You do know that the comments have a âPreviewâ button, right? I know Iâm being pedantic, and from the strictly logical point of view, these errors do not damage your argument, but for cyring out loud! Really?

Al Sears, . . . Jo Mercola, ⦠Marcia Engel

Who on earth are you talking about? If you canât even get the names of your own heroes right, why I am supposed to take you seriously?

To everyone else: I donât think that Pegasus is Emily. At least Emily could spell.

Once again, Pegasus: http://www.wikipeetia.org/Marcia_Engell

Well Chris, it's amazing how much has changed in 70 years, I agree. I suppose what happened in 1798 is even more preposterous. And keep referring to me as Emily if you prefer, & I'll call you Christine. Fair deal?

You haven't answered my last question:
What percentage of medical practice on any given day would not qualify as science-based medicine?

First, my name is not "Christine." You may have noticed that the comparison between you and Emily is due very suspicious similarities. Though, Chemmomo has a point, she could spell.

Oh, and your question is actually quite stupid and unquantifiable. I also have no obligation to answer any of your questions until you answer those I posed to you. Here, I'll give you a break: explain exactly how babies can be protected from pertussis supported by real scientific citations.

PS. Peggy - your logic is wrong.

"It's your job to prove it because you're the one promoting the risky intervention, not me..."

Nope. The scientific consensus is that NON-intervention is the riskier option. Vaccines are not just safe, they are BETTER than safe. They actually save lives.

Sure, you disagree - but you cannot argue that the vast majority of the world thinks otherwise (hence vaccinations are routine).

Therefore, it's your theory of 'risky intervention' that needs proving.

I guess you'd be happier if people still got smallpox, tetanus and polio. Or if a few million old people died of the flu each year.

The good old days before vaccines, hey?

What percentage of Pegasus' posts contain not one iota of science, Chris?

Why don't you answer my questions about the recent measles outbreak in Hennepin County, Pegasus? You're the one who keeps blathering about your secret knowledge of medicine and science without any citations.

lilady:

What percentage of Pegasus' posts contain not one iota of science, Chris?

Oh, about 0%. And as far as Chemmomo's observation of Pegasus ability to spell, his/her last comment was signed as "Pegsus." And yet he/she keeps digging.

Though to be fair, "Al Sears" is an alt-med peddler separate from Dr. Bob. I am amused by Mercola being given a sex-change and given the common nickname of "Josephine."

Chris...just what is Peggy's alternative to "germ theory"? And, what is Peggy's alternative to "herd immunity"?

Mighty long on bullshit and short of facts and citations... our Peggy.

Pegasus @ 315:

I believe in Lord Rutherford's statement: that the only pure science is physics, all the rest is stamp collecting.

Then ask Lord Rutherford (who also said anybody who talked about getting appreciable amounts of energy from nuclear reactions was "talking moonshine") about the very simple arithmetic involved. An infected person can infect a certain number of other people while his disease is contagious, just as a fission neutron can cause the fission of other nuclei which release more neutrons, etc. etc.

You like physics. Congratulations! So do I! If each fission neutron of the ~2.5 (for plutonium) goes on to cause an average of more than one additional fission, the chain reaction will grow exponentially. Less than one, it will die out. You need to know the cross section (infectivity) of the reaction (disease) the density of the material, and its size (population), but given those easily measured values, you can calculate precisely how the reaction will go. The critical mass below which (susceptible population below which) the chain reaction (epidemic) will fizzle out can be exactly determined. The equation describing the two situations is identical. The experiment has been done. The subcritical mass doesn't explode. Assemble a large enough mass in one lump (or reduce its surface area so fewer neutrons on average escape before reacting (fewer people can avoid exposure) and: "Boom!"

Isn't experimental science wonderful? Not that it needed to be tested: The arithmetic is elementary. They dropped the bomb on Hiroshima without a test. Because it was uranium 235 and was all they hadâbut confidence was absolute. The math works.

By The Very Rever… (not verified) on 17 Mar 2012 #permalink

Lilady: No, I'm not kidding, I'm very serious. The CDC account states : 'The investigation determined that the index patient was a U.S.-born child of Somali descent'. How was that determined? Please furnish unambiguous evidence, not that I would attach any significance to it.

'Measles was declared eliminated from the United States in 2000. However, importations of measles from other countries still occur, and low vaccination coverage associated with parental concerns regarding the MMR vaccine puts persons and communities at risk for measles. Public health and health-care providers should work with parents and community leaders to address concerns about the MMR vaccine to ensure high vaccination coverage and prevent measles'.

How long had measles been eliminated prior to the CDC's confident statement? One week? One month? One year?

So before 2000 there was no importation of measles? Were the borders sealed before 2000, allowing no importation? Or did they do double sprays on the planes with a secret brew from Locker 59 before they landed? There were areas in the States with lower vaccination rates before 2000 so how could the country be declared measles-free, as this is supposedly one of the main 'causes' of outbreaks? Just maybe it's a furfy!

What was the nutritional intake of the 13 like? How many of the CDC who recommended such drastic control measures had financial links to vaccine manufacturers?

Remember your germ theory- there is the host, the microbe & the interface. Multi-factorial. Much guesswork.

The report raises more questions than it answers, like almost all government reports on health. No wonder Professor Ablin gave the establishment a spray!

I for one, & I'm not alone, do not share your trust in the government agencies. I, like an increasing number of Americans, have a decided distrust, in fact. And I'm still waiting for your estimates of the percentage of modern medicine that you clubbers agree is not science/evidence based.

Centuries ago evil spirits were blamed for disease. Then we had bad karma. Then it was the humours. Then germs. Then stress. Then genes. Then the ubiquitous claim 'you got a virus'. No wonder Dr Fuhrman titled his second chapter in SuperImmunity " The Failure of Modern Medicine". Have a read clubbers you might learn something.

The Very Irreverent Battleaxe of Knowledge: Germ theory & Herd immunity theory, are just what their name states: theories, & have been named as such in medical textbooks.

Wow, Peggy! You really marked yourself as ignorant with that one! "Theory" means "a possible explanation that we're not yet sure of" only in casual conversation. In a scientific context, such as the one where you are now flailing out of your depth, it means a set of well-tested principles we are very sure of, that we use to make sense of further observations.

If you opened up a basic economics textbook, on the first page you might read something like "in basic economic theory, actors are classified either as sellers, who exchange a good or service for currency, or buyers, who exchange currency for a good or service." Are you really lame-brain enough to think the word "theory" in that sentence means we are only guessing that some people sell things and other people buy them?? It means the opposite!

Seriously, newbie mistake there!

By Antaeus Feldspar (not verified) on 18 Mar 2012 #permalink

You're going to need a citation for that one. Peer reviewed. Showing unvaccinated children get convulsive febrile seizures at the same rate as children given MMR. There is plenty of peer review to suggest that you are wrong.

I'm sure you have a citation for that.

For vaccine damage and failure? Of course you don't. No skeptic would.

Because it's not like there'a fund set up for compensation in cases of vaccine injury or anything like that.

Are you playing the "she would have ended up with brain damage even if she didn't have the MMR vaccine" card?
That's pretty unscientific of you.

No, I'm saying her condition puts her in a higher risk group than average.

You must be a neurologist.LOL, Sorry I forgot. You're just dedicated to lurking.

So I can't possibly understand the mechanism of a seizure unless I'm a neurologist?

Now you're really lurking and getting away from mechanism of action of vaccine induced brain damage.

Is there something different about a vaccine induced febrile seizure versus a febrile seizure caused by something else?

Oh, and BTW then why do so many parents use tylenol for fevers? Why exactly have they been scared to death about febrile seizures?

Because a febrile seizure looks scary? Because high fever is uncomfortable and they don't like seeing a child in pain?

There's a book on Hannah Poling, Bailey Banks, and the thousands of others whom are medically induced vaccine brain damaged?

No, but there are books about the general mechanisms of the conditions in question.

By dedicated lurker (not verified) on 18 Mar 2012 #permalink

Pegasus @333:

How was that determined? Please furnish unambiguous evidence, not that I would attach any significance to it.

So, you're not discussing this in good faith at all. Thank you for acknowledging that it is pointless for anyone to respond to any of your questions.

Pegasus @333: Why should anyone bother to give you evidence, since you have stated that you would not attach any significant even to "unambiguous evidence"?

Also, with regard to theory: that's like saying that gravity is "just a theory" and being surprised every time you drop something and it hits the ground. The thing about a scientific theory is that it holds whether you believe in it or not. You don't have to believe in gravity for things to fall in consistent ways when you drop them. And you don't have to understand or believe in germ theory for a virus or bacterium to make you sick. Fortunately, that works both ways: denying germ theory won't give you a case of smallpox.

Pegasus,

I'm still waiting for your estimates of the percentage of modern medicine that you clubbers agree is not science/evidence based.

Perhaps this article will answer your question.

Thus, published results show an average of 37.02% of interventions are supported by RCT (median = 38%). They show an average of 76% of interventions are supported by some form of compelling evidence (median = 78%).

It's worth noting that a number of interventions are not amenable to RCTs as this would be unethical, and that the article was published 12 years ago. I think it is likely that evidence (and science) based medicine has become even more widespread since then. Dr. Steven Novella has said that:

My personal experience is that nearly 100% of the clinical decisions I make are based upon the best available evidence combined with plausible and rational extension of what is known. I canât think of any time when I use treatments that are based upon nothing, or even nothing but anecdote.

By Krebiozen (not verified) on 18 Mar 2012 #permalink

Augustine,
You appear to still be arguing that vaccination (and indeed, any preventive medicine) is only of use to the people who will actually get the disease in question and suffer severe effects from it. Is there a test (other than an actual infection) that will tell who has a high chance of being injured by, say, Chicken Pox? If so, where is the evidence for said test? If not, why not?

By Mephistopheles… (not verified) on 18 Mar 2012 #permalink

Pegasus,

No one would know for sure. There have been vaccination rates fall in many areas ( my own area for eg) yet there have been no outbreaks of any infectious diseases. It. is. not. predictable.

If vaccination rates have fallen far enough the population is vulnerable, and sooner or later the disease will be introduced by an infected person from outside and there will be an outbreak. What you are suggesting is analogous to arguing that long, hot, dry summers don't cause forest fires. They don't, directly, but they leave forests vulnerable to fires if one is introduced.

Some reading for you. Firstly look at the table on this page for pertussis vaccination rates, cases and deaths in the UK between 1970 and 2008. Then read part 4 of this article which notes, of the scare caused by a paper published in 1974 that suggested (erroneously as it turned out) a link between DTP vaccine and acute neurological illness:

The impact of this controversy on immunisation uptake and disease outbreaks was staggering. By 1977, pertussis immunisation uptake was down from 77% to 33%, and some districts even recorded an uptake rate of just 9% (Swansea Research Unit, 1981). In terms of disease burden, at least four significant outbreaks of whooping cough occurred during the course of the vaccine scare. The first of these, in 1979, had 102,500 reported cases throughout the United Kingdom and an estimated 36 fatalities.

In case you wonder, the figures in the table don't match those in the article because one refers to the whole UK and the other to England and Wales. My son, who couldn't be vaccinated for medical reasons, got whooping cough in the UK in 1981 when there were 8 times as many cases as there were in 1973, the year before the scare story started (both were trough years before you pick up on that).

You will find it hard to persuade me there was no connection between the vaccine scare, the subsequent fall in vaccine uptake and the huge increase in cases.

By Krebiozen (not verified) on 18 Mar 2012 #permalink

Peggy: Here is the Measles Case Surveillance Guideline presently used in New York State, by epidemiologists while investigating a case or cases of measles. The CDC Measles Case Surveillance Chapter from the CDC Vaccine Preventable Disease Surveillance Manual is presently being revised for inclusion in the Revised Manual:

http://www.health.ny.gov/prevention/immunization/providers/docs/measles…

Feel "free" to critique any of the steps or any of the laboratory tests to confirm a case of measles, to epidemiologically link a case and how the "index" case is determined to be a particular case of measles, after the measles outbreak investigation is completed. But, you better have a link or links to citations from reputable sources...otherwise we might think you're an ignorant citationless troll and bullshit artist.

Pegasus,

Centuries ago evil spirits were blamed for disease. Then we had bad karma. Then it was the humours. Then germs. Then stress. Then genes. Then the ubiquitous claim 'you got a virus'.

Your grasp of history is as bad as your grasp of germ theory, I'm afraid. There are a few things wrong with your statement - for instance, a virus is classed among germs. Some diseases once thought to be caused by stress (peptic ulcers) are now known to be caused in the vast majority of cases by germs (Helicobacter pylori). There is a vast body of evidence going back to the 19th century that certain diseases are caused by certain germs, though clearly not all diseases are cased by germs.
If not, please explain the anthrax outbreaks of 2001.

By Mephistopheles… (not verified) on 18 Mar 2012 #permalink

After Peggy slogs through the Measles Case Surveillance Manual and provides us with his/her "critiques" and links to "alternative" measles case surveillance...the ignorant troll might want to peruse this report from the WHO. It details the eradication of indigenous measles in the Western Hemisphere:

http://www.who.int/bulletin/volumes/82/2/134.pdf

This WHO bulletin shows that eradication of measles in Europe and the U.K. might have been accomplished...were it not for the activities of Wakefield, alternative "experts" and the credulousness of parents who are clueless about measles and the MMR vaccine.

@Pegasus - wow, you do have little or no knowledge of disease survelliance. After 2000, there were no more cases of "domestic" measles in the US - we were finding links to overseas exposure as the source cases for outbreaks (up to and including today as well).

These anti-vaccination parents seem to love to take their kids into areas of the world where measles (especially) is still endemic - and now with the growing outbreaks in continental Europe (particularly France, a very popular vacation spot), we will probably see an increase in disease imports, which makes it that much more important to keep up vaccination rates here to prevent the spread of measles here from abroad.

"Please furnish unambiguous evidence, not that I would attach any significance to it."

Priceless.

Show me the proof, I'll shut my eyes!

Another spectacular example of why anti-vaxxers like Peg are among the stupidest, yet most arrogant people on Earth.

Peggy, please explain your stunning contradictory position. If you don't believe in germs causing disease (lol!), then why are you bothered about germs in vaccines?

Actually, don't bother replying. Seen too much flying horse shit for one day.

PS. Hope you're enjoying some harmless, germ-free raw chicken... Hey, why not serve it to un-vaccinated kids too?

You're so dumb it hurts.

@ Lawrence: Case surveillance of any disease (vaccine-preventable or not), is not for amateurs.

Case surveillance of vaccine-preventable diseases is "easy" compared to case investigation for a food-borne illness, vector-borne illnesses such as West Nile virus and tuberculosis case surveillance and containment.

Here is a short history of the Epi-Info (TM) computer program that was developed by the CDC more than 20 years ago that has now been adopted by other countries and by the WHO for enhanced case surveillance. Epi Info 7 (TM) is now available for case surveillance:

http://wwwn.cdc.gov/epiinfo/

Does Pegasus still think we in public health manage disease outbreaks and case surveillance, by "making it up as we go along". Just what "alternative" epidemiological program does Peggy use?

Pegasus/Emily/D.F.:

I, like an increasing number of Americans...

Here's an example of one of the insurmountable problems you face in attempting to persuade others here: You're dishonest. As we both know, you're not an American.

This sort of lie, coupled with your changing of identities and denial thereof, fatally undermines your credibility. Add in your concealment of your financial interest in the position you are espousing (e.g. CD/DVD sales, seminars, etc.), and there's little reason to even consider your statements, as riddled with potential deceit and conflicts of interest as they are. And you apparently haven't considered the effects on your co-workers' and clinic's reputations your deceitful behavior here could cause.

I direct your attention to the set of questions you have still failed to address in the Burzynski thread. Your continued evasions tell the fair-minded reader all s/he needs to know.

By OccamsLaser (not verified) on 18 Mar 2012 #permalink

I will be off-line for a few hours...it should be enough time for Peggy to provide citations and links to his/her "alternative" germ theory and his/her knowledge of epidemiology and disease surveillance.

Too too bad, Pegasus, that you put your faith in bogus science, never got any education in science and are still supporting the defrocked doctor.

*There are too many variables*(and probably,too many notes)

Which isn't my main point- woo-meisters frequently bring up physics- (search terms like quantum above )- you might wonder why. OK, I'll tell you: not everyone studies physics and it sounds *impressive*! Native territory of geniuses and scientific revolutionaries- perhaps thinking that it might rub off, woo-meisters speak in hushed tones of Einstein.. Newton.. Rutherford.. Feynman.. They harp reverently on their own explorations in this sacred realm. We hear about quantum this-n-that and various entanglements.

I propose that physics is their "*science* of the gaps"- while postulating alt med hypotheses when they encounter an area they don't understand they toss in terms nearly arbitrarily, hoping that no one will notice and that it makes them appear brilliant. Remember many of these people accept homeopathy.Which is based in physics and mathematics.

Everything we do involves multiple variables- whether you like it or not- here's a real world example: there's a huge drop in the market- stock prices are down to record lows. We know that they will most likely come back up - even a dead cat bounces if you toss it from a great enough height- so a wary investor chooses stocks that she believes are worthwhile despite their current abysmal level. She finds multiple indices that inform her which ones will soar- i.e. they're not just dead cats bouncing- and buys at the low. There are loads of variables to consider and ways to discrimate which ones are the most salient- people do this for a living, you see. The buyer can't know everything about the stock and the future but she can still make money.

Translating this scenario to vaccines: she has information about the current flu vaccine and herself- including her social and physical environment. Lots of variables again:putting everything together- risk of illness, health status, environmental factors- she sets a criterion about what level of risk is acceptable to her- just like she does in her market adventures: again she needn't know 100% to make a reasonable choice.

By Denice Walter (not verified) on 18 Mar 2012 #permalink

OccamsLaser,
To be fair, the phrase "I, like an increasing number of Americans..." does not require the writer to be an American for it to be true. One may infer that the speaker is a member of the same class as "the increasing number of", but it isn't necessarily the case.

By Mephistopheles… (not verified) on 18 Mar 2012 #permalink

Mark M @344 Peggy shows almost a textbook example of the Dunning-Kruger effect.

By Steelclaws (not verified) on 18 Mar 2012 #permalink

Pegasus, Iâm going to repeat my questions from #325:
Could you please explain (a) to whom you refer as

Al Sears, . . . Jo Mercola, ⦠Marcia Engel

And (b) why exactly I should take anything you have to say seriously?

Your grasp of history is as bad as your grasp of germ theory, I'm afraid.

The invocation of karma wasn't too promising on the comparative religions front, either. Bija niyama isn't karma niyama.

Anyway, I should make perfectly clear that I don't think Pegasus is Emily, and I should have been more cautious not to suggest otherwise. I was simply drawing a parallel to highlight the dully repetitive tropes and tactics that seem inevitably to emerge when antivaccine logorrhea is the order of the day. It's as though there's but one threadbare carpetbag of tricks that just gets handed around.

I'm not hiding, but I am running, so will make just a couple of points.

I don't attach significance to the determination of the index patient because to me it is not relevant.

Now I see from the Burzynski link why I am being flatteringly linked to one Emily. Sounded like she spoke sense, although I need to brush up on her natural hygiene.

I look forward to scrutinising the links in the next day or so.

But you have refused to answer my questions, Pegasus.

So, exactly what your magic plan to prevent diphtheria, tetanus and pertussis in infants?

@ Pegasus: I believe it was you who questioned the finding of the index case by Hennepin County public health officials during the 2011 measles outbreak in Minneapolis:

"Lilady: No, I'm not kidding, I'm very serious. The CDC account states : 'The investigation determined that the index patient was a U.S.-born child of Somali descent'. How was that determined? Please furnish unambiguous evidence, not that I would attach any significance to it."

So I provided a link to the measles case surveillance protocol...and you still haven't opened the link or, perhaps you did and your limited knowledge of disease process prevented you from understanding how case investigation is done.

First and foremost...you reject "germ theory" and have not provided us with any of your "theories", along with *citations*.

Citations like this are not acceptable:

http://en.wikipedia.org/wiki/Miasma_theory

We've come a long way...with the discovery of bacteria, viruses, parasites and prions that cause diseases, the discovery of the routes of transmission of communicable diseases, the development of vaccines to prevent often deadly diseases, accurate laboratory tests to diagnose diseases and effective medicines to treat these diseases.

We've also backslid, due to the efforts of your hero, the disgraced/defrocked doctor and the credulous people who still believe in his quackery.

Sounded like she spoke sense, although I need to brush up on her natural hygiene.

Oh, you'll love it. Remember, it's very important not to combine melons with other foods. Wisdom of the ages.

I need to brush up on her natural hygiene.

Don't miss the bit about menstruation being a curable disease, though even Emily balked at swallowing such a huge mouthful of natural hygiene nonsense.

I still find the remarkable similarity between Emily and Pegasus's postings very suspicious. Maybe they are related, or are just regurgitating stuff from the same website somewhere? PSA screening, Fosamax in osteopenia, Angell and the FDA, Fuhrman et al, "science today becomes nonsense tomorrow & vice versa", Ray Strand "100,000 Americans are killed yearly" etc etc.

By Krebiozen (not verified) on 18 Mar 2012 #permalink

Menstruation a curable disease? Well, time cures all ills.

@ Krebiozen:

Much of the quotes, names and ideas are painfully familiar, courtesy of web woo. From skimming Peg's comments above: nutrition isn't taught in med school, off-hand scoffs at germ theory and genetics, sanitation not vaccines decreased illness, nutritional solutions for illness, return to nature, Fuhrman, Ornish, Klaper et al, dangers of rx drugs, mistrust of triumvirate of medicine, government & media, pharma mischief leads to 3 billion in fines...

These ideas may be attractive to audiences ( customers) because they already have an axe to grind. Some of the articles' titles at the dens of iniquity I survey trumpet discontent with the status quo and SBM. They wish to return to Eden before pesticides, antibiotics, GMOs, SSRIs, vaccines and aspartame polluted the place beyond recognition, while forgetting about oh... TB, cholera, polio, malaria, child-bed fever etc in the western world.

By Denice Walter (not verified) on 18 Mar 2012 #permalink

I would just like to thank the commenters in here that know a hell of a lot more about medicine, epidemiology etc. than I do, that is know you Pegasus, or Augustine. The back a forth between you and these utterly stupid trolls, the part about germ theory not being right is one of the more idiotic things I have ever read.. It brings to my attention many new peicess of information that I wouldn't have found on my own course of study in biology and vet med, though the vetrinary med helps a little when it comes to medicine.

@Pegasus
So I just thought of a question for you. If disease, only talking about those caused by organisms, are not caused by bacteria, viruses, prion, or other organisms, how is neurocysticercosis caused? Just so you know the cause of it. Neurocysticercosis is caused by larvae, cysticercoids, the tapeworm Taenia solium,aka the pork tape worm, that have encysted in the brain of a person. It is clearly evident in MRIs. Yes, you can argue that it is nutrition since you get it from eating undercooked infected pork but there a causative organism.

@Denice Walter

off-hand scoffs at germ theory and genetics, sanitation not vaccines decreased illness

This is what I don't get about hard core alties. If germ theory is nonsense, why should improved sanitation do any good?

By Militant Agnostic (not verified) on 18 Mar 2012 #permalink

@ Militant Agnostic
One the same topic it always make me laugh when the bring up Ignaz Semmelweis as an example of of somebody who ostracized, because if Germ Theory is wrong why would Ignaz Semmelweis even matter because hand washing wouldn't matter.

@ Militant Agnostic:

I don't pretend to entirely understand their twisted world-view which has more turns than a mobius ring- however, they are consistently inconsistent- e.g. they say stress causes illness but they continuously stress out their audiences with their sky-is-falling shrieking about every conceivable thing that could _possibly_ go wrong under the sun ( or on the sun- solar flares,you know). ( World weary voice) I've seen it all.

It's a miserable job, but somebody's got to do it. Unfortunately, I believe that the big guns are out to bury psycho-pharmacology next. Interesting that they hate psych meds so much.

By Denice Walter (not verified) on 18 Mar 2012 #permalink

Meph -

To be fair, the phrase "I, like an increasing number of Americans..." does not require the writer to be an American for it to be true.

Fair enough -- let's get a clarification.

Pegasus - are you claiming to be an American?

I will, in the interim, substitute a different example of a falsehood. Pegasus writes,

Herd immunity is total BS & is one reason among many why my wife & I have not vaccinated our children, & never will.

Pegasus, as she knows, does not have a wife.

And Pegasus, I am stil awaiting your disclosure of your financial interest in the therapies you promote -- clinic income, seminars, CDs, that sort of thing. Your silence is getting louder.

By OccamsLaser (not verified) on 18 Mar 2012 #permalink

@Pegasus
You said (in 284) that "the doctors I mentioned (...) understand the role of nutrition in the prevention & treatment of disease."

As you used this to refute another posters point, I assume you believe these doctors to be correct. Namely, that nutrition can prevent diseases?

So, I have a couple of questions for you.
1. Can nutrition prevent a "vaccine-preventable" disease, Measles for example?
2. If enough people follow the correct nutrition (lets say 80% for conveniences sake), can this provide what is commonly called "herd immunity", or equivalent natural counterpart?
3. How does the math of this naturally induced immunity differ from the math given in post #300 by Antaeus Feldspar , which you did totally reject in post #308.

"quotation marks" added so that posters wouldn't just argue that they don't believe vaccines prevent anything or there is no such thing as herd immunity and so on.

And I promise I'm not asking just to ignore your answers or to break them down to find any single error or typo in there to ridicule what you said with that. I'm genuinely interested.

Thank you,
-gaist

@Pegasus

Does your committment to never vaccinate your children extend to refusing them post exposure vaccines such as Rabies (when bitten by a rabid dog on holiday in Thailand), or tetanus (when scratched by a rusty nail while gardening) or Hepatitis B (when stabbed by a drug user's needle found in the toilets of a MacDonalds).

Rather than dismissing these events as something that would never happen, tell us what you would do if one of them did happen.

Theory: " supposition or system of ideas to explain something"' Minerva dictionary. " A set of ideas formulated to explain something, an activity upon which an activity is based" Oxford dictionary.

Germ theory is an explanation of diseases which are associated with microbes. It is useful, just as glycemic index is useful in nutrition, but, like GI has great limits in explaining BSL regulation, so GT is not an all encompassing explanation of microbe-associated diseases. There are many anomalies, which, if you are honest, you would acknowledge.

"And you don't have to understand or believe in germ theory for a virus or bacterium to make you sick" says Vicky. Herein lies the problem. Germs do not equate with disease. The microbe needs co-factors. My own doctor whom I very occsionally see even said to my wife & I when I asked her if she had flu shots herself: no, I'm too healthy for that! Well let me assure you, the Health Department would not take too kindly to her comment, or her inference. On the very wall of her clinic, was a poster about flu which had 5 points to avoid the flu- none of which mentioned health! But I do agree with her.

I refuse to have flu shots & never get the flu, despite being exposed to it regularly.

And when the exact symptoms of flu are seen in a patient whose bllod tests are negative, they call it "flu-like". Very convenient.

Gaist: Firstly, I don't believe that nutrition can prevent all diseases, either "infectious" or degenerative. There are no guarantees. But it helps enormously. And superior nutrition is not achieved by complying with the nutritional recommendations of the USDA, which is dancing to too many commercial flutes.2) imo no

Chemmomo: Dr Al Sears, Dr Josepph Mercola, Dr Marcia Engell (spelt correctly)

"But you have refused to answer my questions, Pegasus.

So, exactly what your magic plan to prevent diphtheria, tetanus and pertussis in infants?"

Magic? Nice one!

I personally have trodden on an old nail & punctured myself with a few other objects throughout my adult life, & have never had tetanus shots. I have had stitches medically, & also refuse antibiotics. I accept some things medical, & reject others. That is my choice. I don't expect anyone else to do what I do, they can choose their own path.

You live as healthy as possible, which btw means taking very little heed of public health messages, & you do your best.If perchance sickness occurs, then a rational approach is taken, which on most occasions, does not mean pharmacological interventions at the outset. Your assumption that I, or any other woo-meister, really believe that you can 100% prevent of cure anything is your way of establishing the ground rules & then you come in for a clubbing. So please don't ask me to justify a certain position that you have established for me.

Lilady, Denice & Matt F: Germs exist. They are often associated with disease. The public health view indoctrinated into the gullible public that they are powerless against the microbe without public health interventions is what I rail against & rant about. Cleanliness is the key, not sterility, except if you are a surgeon.

You happen to think I am nuts, & that's fine by me. I happen to think you guys are mistaken on most things pertaining to health, as you have gathered. It's just that I would not mandate that you must follow my views, but you would certainly force me ( & all others) to follow yours if you had your way.

You also outright dismiss, & deride, someone like Joel Fuhrman, who has a remarkable record of helping transform people's health & lives. He is a good man getting out a life-changing message, & you guys don't give him the time of day, just because he, in your opinion, is not "scientific". Same with Professor T Colin Campbell & many others. That is what pisses me & many others off ( including many medical doctors), & why there is so much enmity between your camp & mine.

I honestly don't think it matters at this point whether Peggy is Emily or not. Even if she is not Emily, she's already stuck a fork in her chances of being taken seriously, worst of all by her declaration that even if she was furnished with "unambiguous evidence," she would refuse to "attach any significance to it." Why would anyone be convinced by someone who admits that they ignore even the strongest evidence when it doesn't fit what they want to believe?

It also doesn't help that she's willing on a cursory examination to declare that Emily "sounds like she spoke sense". That speaks to a very primitive mindset where everything polarizes neatly into just two sides, A and B, and if you have already prejudged that A must be wrong and will cling to that no matter what evidence there is, well, then, all you need to know about someone is that their ideas fall into B and presto! 'Sounds like Emily's beliefs make sense, although I admit I don't really know yet what Emily's beliefs are!' Which, frankly, is the same mindset which leads to someone denying herd immunity: mainstream medicine believes in vaccines and in herd immunity, therefore both vaccines and herd immunity must be wrong. And if someone points out that herd immunity is simply a consequence of the fact that a contagious population which does not replenish itself as fast as it loses its members burns out, why, just throw the words "multi-factorial" and "interface" in there and pretend that actually refutes something.

By Antaeus Feldspar (not verified) on 19 Mar 2012 #permalink

@Pegasus,
Thanks for confirming you wouldn't vaccinate your kid if she was exposed to rabies or Hepatitis B.
Now we know what kind of a sicko you really are.

Antaeus: Because I attach no real significance to the index patient does not mean I judge all modern medicine in a dichotomous manner. Because something is medical doesn't mean I automatically reject it. It is not A & B, black & white as you state.

I required a number of stitches recently. Did I reject that because it fell into the realm of modern medicine? No. I was thankful & appreciative of the doctor's skill. However, when he gave me antibiotics before the procedure, I politely turned them down. I did not want them, because I did not need them. Not balck & white, A & B, just shades of grey, determined by my own life experiences.

Similarly, our son cut himself a few years ago. I took him to a doctor, who said he thought stitches were needed, but on discussion he agreed to approximate the tissues & apply a butterfl clip. I politely rejected his advance of a tetanus shot & thanked him for his time, effort & skill. All was well & all remains well with our son.

@368 Pegasus

Yet another Emily trope: never getting sick despite not having been vaccinated. Nice goal post shift for Chemmomo's question by the way; another Emily shtick.

You sure you're not one and the same?

Theory: " supposition or system of ideas to explain something"' Minerva dictionary. " A set of ideas formulated to explain something, an activity upon which an activity is based" Oxford dictionary.

You know, I can look up "relativity" in the dictionary - multiple dictionaries, really. But if I ever went to a blog where a lot of the regular members make their living from understanding relativity and dealing with its consequences, and I tried to argue relativity with them, and proved right away that I had no real understanding of relativity by making a basic blunder on one of the most simple points, and instead of admitting I was wrong tried to cite dictionary definitions to pretend I hadn't actually been wrong -

... well, in such a case, I really hope that those who love me would be able to intervene, and drag me away from the keyboard until I regain some self-control and stop acting like such a moron. I wonder if Peggy has anyone who cares enough to try and stop her from making an ass of herself.

Oh, and Peggy, I noticed that you answered a very important question from gaist with less than 10 letters, not one of them a capital letter ... I dunno, almost as if you were hoping to avoid it being noticed or something. It's when you admitted that you believed that "superior nutrition" is a method that "helps enormously" in keeping exposure to a disease from becoming contraction of a disease, and then, to the next question of whether a herd immunity effect would result if enough people were "helped enormously" by that method, said "imo no."

Well, now, that's a very surprising combination of opinions! It's like saying "I believe that people can grow to six feet or more, but I don't believe that two people working together can touch a ceiling that's ten feet high." To believe in the first and yet *not* believe in the second doesn't make a lot of sense! "I believe that wearing good running shoes can help enormously in running faster! But will a team running a relay race finish any faster if the majority of the team is wearing good running shoes? uhhh... imo no."

I'd ask how you could possibly reconcile the two... but I think we already know that. You just decided "I believe that my alt-med gurus are right and mainstream medicine is wrong and even if unambiguous evidence contradicts those beliefs, I won't attach any significance to it."

By Antaeus Feldspar (not verified) on 19 Mar 2012 #permalink

Pegasus,
Why are you repeating my question from #325 in comment 368? You didnât actually answer it.
My original question was:

Could you please explain (a) to whom you refer as
Al Sears, . . . Jo Mercola, ⦠Marcia Engel

You replied

Chemmomo: Dr Al Sears, Dr Josepph Mercola, Dr Marcia Engell (spelt correctly)

Huh?

First of all, letâs deal with Mercola. Thereâs only on âpâ in Joseph. Yeah, you know what? Iâm not too good at proofreading either, so weâll let that one slide.

But who on earth is Dr Al Sears? Do you mean Dr William Sears, coauthor of numerous parenting books, or do you mean his son, Dr Bob Sears, inventor of his very own alternative vaccination schedule promoted in his "the Vaccine Book"? Or are you talking about someone else entirely, whose name is actually Al Sears, and if so: who is it?

And if you are trying to support your ideas by quoting a certain former editor of the New England Journal of Medicine, it helps if you manage to spell her name right. And guess what? Youâre still wrong! Marcia Angell is spelled with an âA.â Donât believe me? Click on the blue text. It links to a search for her articles on pubmed: http://www.ncbi.nlm.nih.gov/pubmed?term=%28Marcia%20Angell[Author]%29

Let me finish by repeating my part b from #325:
Why exactly should I take anything you have to say seriously?

Chemmomo:

"First of all, letâs deal with Mercola. Thereâs only on âpâ in Joseph. Yeah, you know what? Iâm not too good at proofreading either, so weâll let that one slide".

I see. You have never rushed & made mistakes with basic spelling or grammar? Please read your second sentence. We'll let slide as well.

Pegasus,
I don't consider you crazy. I consider you poorly informed and incapable of a sensible discussion. I believe you came in with no particular point except, perhaps, "you-all don't know everything." I believe you talk in vague generalities and believe your own personal experience trumps data and statistics.
Just for the record, I have not missed a day's work for sickness in several years. I have stepped on a nail and didn't immediately get a tetanus shot (even though I know there's a risk, and if you do get tetanus it can be pretty horrific). I suffered all of the standard childhood illnesses in the days before there were vaccines against many of them. I'm willing to bet I don't do exactly the same things you do to stay healthy. So - who here is more right by anecdote?

By Mephistopheles… (not verified) on 19 Mar 2012 #permalink

"Lilady, Denice & Matt F: Germs exist. They are often associated with disease. The public health view indoctrinated into the gullible public that they are powerless against the microbe without public health interventions is what I rail against & rant about. Cleanliness is the key, not sterility, except if you are a surgeon."

Is that your "germ theory", Pegasus? And, is that the knowledge you impart to your children, as well? Your kids and your family must be in awe of your intellect.

If sterility is not the issue, why don't you ask your dentist to reuse the needle/syringe that was used on other patients, to anesthetize you for treatment?

Nice going Pegasus; because of your colossal ignorance you may expose a vulnerable infant or an immune suppressed adult to a serious disease.

I'm getting a bit fed up with this wonderful nutrition and no such thing as herd immunity nonsense. Herd immunity is not needed anyway because wonderful nutrition has a force field preempting such plebeian effects impinging on the exalted always eat right folks. I presume I read these people aright.

When it comes to wonderful nutrition you couldn't beat the naturally grown fresh fruit, veg, meat, fish and shellfish provided easily and abundantly, if not to say lavishly, for the riverside and beachside communities of the indigenous people of Australia. Much better diets than the under-nourished, pasty faced convicts, soldiers and other settlers of the invading Britons.

But who exactly was it that died in droves from measles, chickenpox and smallpox? No, funnily enough, it wasn't the often hungry newly arrived subsisting on salt beef, overboiled veg and distinctly unwonderful bread. It was the robustly healthy, well-fed indigenous people who also, it might be added, spent all their lives in the healthy open air so beloved of certain advocates.

And then it came time to 'deal with' the not quite so constantly well fed people of the desert interiors. People who claimed to believe in miasma theory seemed to know enough of germ theory principles to supply smallpox carrying blankets to infect the locals. Nobody was surprised when they died in droves as well.

Similar disasters befell indigenous Americans of both north and south continents. Very few communities within these groups had diets as bad as, let alone worse than, the invaders.

Good food is good for you. But it has no force field or other magical properties to shield you from disease.

Chemmomo:

I've just read your pubmed lists of Marcia Angell's articles. Interesting reading the CAMJ 12/2004 Excess in the pharmaceutical Industry. Do you blame people for not trusting bigpharma? And her reason why doctors don't speak out about this incestuous influence? (apart from the few brave ones like McDougall, Fuhrman et al) Show me the..money, gifts, perks, holidays. What a freakin' disgrace.

@Pegasus
"Germ theory is an explanation of diseases which are associated with microbes. It is useful, just as glycemic index is useful in nutrition, but, like GI has great limits in explaining BSL regulation, so GT is not an all encompassing explanation of microbe-associated diseases. There are many anomalies, which, if you are honest, you would acknowledge."

Well except for the fact that the Germ Theory of disease has saved thousand of lives. Once the evidence supported the most disease is caused by microorganisms it allowed doctors to really know what was behind these illnesses. I could name several doctors/scientists, that around this time came up. While yes disease has many other things associated with, as many symptoms are caused by the actual immune system, ex. paroxysms and fever associated with Malaria, it is the underlying cause is the organisms itself. Yes, there can be confounding issue, a compromised immune system for any number of reasons, there still is the actual cause. Somebody already said not all disease are caused by etiological agents, but many are.
Just so your clear what is you theory on disease, are they caused by nutrition, or do you still think the old germs are a consequence of disease is right?

Chemmomo:

I've just read your pubmed lists of Marcia Angell's articles. Interesting reading the CAMJ 12/2004 Excess in the pharmaceutical Industry. Do you blame people for not trusting bigpharma? And her reason why doctors don't speak out about this incestuous influence? (apart from the few brave ones like McDougall, Fuhrman et al) Show me the..money, gifts, perks, holidays. What a disgrace.

Show me the money?

Your 'hero' Wakefraud was paid £430,000 to find problems with MMR.

He falsified his research (LIED, in other words), got caught red-handed and was struck off.

If the scare had worked, he stood to make MILLIONS. Even discredited, he's still raking it in. Just like cancer quack Burzinski (another 'poor crusader' living in a mansion).

A disgrace, indeed.

@ M'OB, 377:

I don't consider you crazy. I consider you poorly informed and incapable of a sensible discussion.

I'm willing to go with straight-up bad faith.

Many years ago I attended a talk by Dr Archie Kalokerinos, an Australian doctor who was one of the first to link the 3 month triple antigen with SIDS. He wrote a book called Every Second Child. According to him, he was the first person to ever conduct an autoposy on a SIDS baby immediately after death. His finding of vaccine-induced scurvy in this case led him on a life-long journey warning people of the dangers of vaccination.

During the talk he related a story he experienced while he was in Africa. He was filming the early public health vaccination programs. When the 'white man's" medicine was first introduced (vaccinations to "protect" them) & the buses with the nurses & doctors etc rolled in to the rural communities, he said the natives would rush over with their bambinos in their arms, eager to have their young babies vaccinated.They were keen to have their babies vaccinated.

He said when he went back to the same villages to see the second wave of "white man's" medicine some time later, the natives literally ran & hid in the bushes with their bambinos, voting against further vaccinations with their feet.

They obviously knew something which prompted their fear. They knew their babies were not the same after "white man's" needles. Instinct led them to protect their young.

The same thing is happening today in the western world. Many mothers are not speaking with their feet, they are speaking with their anger & their voice, just like Jenny McCarthy.

Do you people really think that the outcry about vaccinations by an ever-increasing number of lay & professionals alike is because they are morons? They are stupid? Or are they all shit-stirrers, just out to bring down the medical/drug establishment?

Why are so many mothers complaining of changes in their babies/children's health & development soon after vaccination? Are they self-deluded? Are they just out to cause trouble? Maybe they are like the natives in Africa Dr Kalokerinos witnessed, running off with their children & hiding in the bushes.

Why don't we see the same intense sentiment from people concerning other routine medical/ dental procedures eg colonoscopies, teeth braces, mammograms etc? Maybe because there are real & serious adverse effects of this out-of-control vaccination program,that's why. And the authorities are playing hear no evil, see no evil, speak no evil. Protect the power base, to hell with the consequences!

I firmly believe, as do many others, that the vaccine schedule is one of the main causes of the increasing rate of childhood diseases & developmental lags.

In my honest opinion, I think it is the worst feature of modern medicine, the full implications of which will unfold in the fullness of time, when the medical profession detaches itself from the drug companies' umbilical cord.

Hail Dr Kalokerinos!

Mark M:

I hope you read yesterday's NYT 19/12/2012 -the health article which blows "the drumbeat" on bigpharma's greed & influence, highliting Dr Relman's & Dr Marcia Angell's scathing attack on the coming "disaster" of modern medicine.

From former Editor of the New England Journal of Medicine, Dr Relman:

"Or, as Dr. Relman summarized one recent afternoon in their sunny condominium here, Dr. Angell nodding in agreement by his side: âI told you so.â

âIâve allowed myself to believe that some of the things I predicted a long time ago are happening,â he said. âItâs clear that if we go on practicing medicine the way we are now, weâre headed for disaster.â

Did you read & understand that? Marcia Angell said it her book: The Truth about the Drug Companies, agreeing with Dr Relman that medicine was in BIG trouble because of self-harm. A slave to drugs!

Let's see all the clubbers who love their drugs, love all the nice doctors who aren't game to rock the boat & tell the truth ( some even on this RI blog),& who toe the line like good little catholics who are faithful to their pedaphilic priests, how do you explain another dissenter whistleblowing & raging against the machine.

The implosion is accelerating.

Dr Archie Kalokerinos

Ah, one of the apologists for baby batterers. OK.

By herr doktor bimler (not verified) on 20 Mar 2012 #permalink

Did you read & understand that?

You clearly didn't understand it. I watched the interview and read the article, and it's very clear to me that it doesn't support your views in any way at all. Relman and Angell are criticizing the private insurance healthcare system in America, not the way medicine is practiced. I agree with them wholeheartedly: I'm a Brit who spent decades working for the NHS willing to accept lower wages than I could get from the private sector because I believe in socialized medicine.

Relman and Angell are complaining that drug companies make healthcare in general and drugs in particular too expensive. They want people in America to have cheaper access to the drugs you think are so evil! Does that make them similar to "pedaphilic priests" in your eyes?

I am quite sure that they would both be horrified to be put in the same category as a raving lunatic like Dr. Archie Kalokerinos.

By Krebiozen (not verified) on 20 Mar 2012 #permalink

They obviously knew something which prompted their fear. They knew their babies were not the same after "white man's" needles. Instinct led them to protect their young.

You know, "Instinct led them to protect their young" is the sort of comment I would use with regard to, say, cats moving their kittens into enclosed and defensible nests. With respect to human beings who "knew" something, I would say that they rationally acted to protect their children.

Of course, I'm assuming for the sake of argument that this occurred and that the villagers had good reason to believe what they believed, as opposed to having just heard a lecture on the evils of vaccination which caused their fears. In fact, we have no way of knowing that this incident even occurred, especially since it was described by someone who also apparently believes in instant scurvy. But the language Pegasus uses to describe the actions of "natives" with respect to their "bambinos" is certainly off-putting.

Pegasus/Emily/D.F. -

You also outright dismiss, & deride, someone like Joel Fuhrman, who has a remarkable record of helping transform people's health & lives. He is a good man getting out a life-changing message

He says the flu is a simple viral illness.

Is he wrong?

Show me the..money, gifts, perks, holidays. What a freakin' disgrace.

Indeed, it is a disgrace that you continue to conceal your own financial interests in the therapies you're promoting. Please reveal how you make money off the approaches you advocate -- clinic income, seminars, DVD/CD sales, that sort of thing. Failure to disclose this information indicates that you are afraid of revealing it, because you know how it could taint your message. But concealing this information does more than taint your message -- it poisons it.

As you've confessed, you don't believe in obeying the core principle of Natural Hygiene, because you promote not eating when hungry (fasting). And, as you've admitted, that's "real" hunger not "toxic hunger", so you can't resort to that evasion.

So you act hypocritically with regard to your health advice, saying one thing but doing the opposite. You've admitted that you're closed-minded, and that you would not change your position even when presented with evidence that undermines that position. You've been caught in lies on several occasions, and you've tried to cover up by lying about why you'd lied. You're concealing your financial stake in the position you're pushing.

And you're complaining about the medical establishment?

By OccamsLaser (not verified) on 20 Mar 2012 #permalink

Pegasus:

Similarly, our son cut himself a few years ago. I took him to a doctor, who said he thought stitches were needed, but on discussion he agreed to approximate the tissues & apply a butterfl clip. I politely rejected his advance of a tetanus shot & thanked him for his time, effort & skill. All was well & all remains well with our son.

So you prefer the "watchful waiting" approach to tetanus, then? Perhaps you aren't Emily, then, because she explicitly said she did not favor "watchful waiting" (although she did decline to clarify what she meant by it).

It is true that most people who get a deep puncture wound without having first been vaccinated or received tetanus prophylaxis will not develop tetanus; the organism is ubiquitous, but it doesn't always produce the toxin. However, the course of the disease is pretty ghastly for those few who do. I find it interesting which risks you prefer for your son.

By Calli Arcale (not verified) on 20 Mar 2012 #permalink

@Calli Arcale

Pfft. Tetanus only has a risk of death of around 1 in 20. Certainly the risks of an adverse reaction from the vaccine are way higher than that.

I firmly believe, as do many others, that the vaccine schedule is one of the main causes of the increasing rate of childhood diseases & developmental lags.

So you admit you have no evidence. All you have is an argument from popularity. Why do you expect to be taken seriously?

Why are so many mothers complaining of changes in their babies/children's health & development soon after vaccination? Are they self-deluded? Are they just out to cause trouble?

They may well be neither self-deluded nor out to cause trouble--they may be detecting real changes in their child's development at that time. Where they go wrong, however, is after the fact, when they attribute those changes to immunization on no basis other than temporal association.

I firmly believe, as do many others, that the vaccine schedule is one of the main causes of the increasing rate of childhood diseases & developmental lags.

From what evidence does this belief derive, exactly? Let's simplify things: what would you offer as the single most compelling piece of evidence indicating a causal relationship between vaccination and increased incidence of childhood disease and developmental lags actually exists?

Pegasus:

Hail Dr Kalokerinos!

He is dead.

Pegasus, what is your plan to protect babies from pertussis, with real references.

"Pegasus" (#385):

"According to him, he [Dr Kalokerinos] was the first person to ever conduct an autoposy on a SIDS baby immediately after death. His finding of vaccine-induced scurvy in this case led him on a life-long journey warning people of the dangers of vaccination."

"Vaccine-induced scurvy"? Scurvy is caused by insufficient hydroxylation of proline and lysine residues in collagen molecules, leading to poor cross-linking and decreased strength. The vast majority (i.e. all but a few) of scurvy cases are caused by a lack of vitamin C in the diet. I have been utterly unable to find any data showing how vaccines can prevent the uptake of vitamin C.

It seems much more likely that the cause of this case of scurvy (if, indeed, it actually existed) was a diet lacking in vitamin C, which, since the patient was an infant, would be the responsibility of the parents.

"Why are so many mothers complaining of changes in their babies/children's health & development soon after vaccination? Are they self-deluded?"

"Self-deluded" is such a pejorative word - I prefer "mistaken". As was so dramatically shown during the US Omnibus Autism Proceedings (OAP), people - including parents - can "edit" their memories post hoc to conform to whatever they believe to be true.

In the OAP hearings, video recorded by the parents clearly showed that autistic behaviors were present before the vaccine(s) in question were given. Why would you imagine that other parents - even mothers - would be exempt from this very common human frailty?

Once again, it needs pointing out that the popularity of an idea is not linked in any way to its validity. There was a time when it was very popular to blame autism (and many other developmental delays) on poor parenting - specifically, the "refrigerator mother". Currently, vaccines are the popular whipping boy. Who knows what it will be a few years hence.

Prometheus

Dr Archie Kalokerinos got tetanus, but he only got a localized infection and survived, probably because he gave himself a tetanus booster immediately after the injury that infected him and was treated with anti-tetanospasmin immunoglobulin. He should have eaten a salad and got a bit of fresh air instead I suppose.

Also, I noticed Pegasus wrote:

Show me the..money, gifts, perks, holidays.

That was banned years ago in the USA wasn't it? I'm sure I have read that doctors can't even accept a free pen or a post-it notepad from a drug company rep any more.

By Krebiozen (not verified) on 20 Mar 2012 #permalink

Oh, I might as well join the fun!

Woo-meisters have an axe to grind- alright *several* axes to grind- against SBM : vaccines and anti-biotics ( more recently, anti-virals) are usually the targets they spy first when they go a-swinging their blades. So why is that?

Because they represent triumphs that have changed how people live all over the world: if we go back a mere 100 years in the western world, people were dying of infectious diseases like TB, polio was not a rarity, malaria killed many who ventured into warmer climes, infected wounds were deadly. Today, we can catch a glimpse of that situation when we visit impoverished areas that have less access to modern medicine... or following a natural disaster.

When an alt med provider harps on the dangers of anti-biotics ( or ARVs for HIV/AIDS) they somehow neglect to tell you what the dangers of NO intervention are. If you travel to areas where malaria is endemic, you can take prophylactic pharmaceuticals; polio has been nearly wiped out and being HIV+ doesn't mean what it did 25 years ago. Prior to AJW's mendacious fear-mongering ( cleverly disguised as research), childhood diseases were being virtually eliminated in the west because of vaccines.

Note to Adelady: altho' I'm one of the pasty-whites, your descriptions are hilarious *and* true.

By Denice Walter (not verified) on 20 Mar 2012 #permalink

Vaccine-induced scurvy? You have got to be kidding me.

News at 11: Vaccines cause your pinkies to fall off, but first, a word from our sponsors.

Not just vaccine induced scurvy--vaccine induced scurvy that looks exactly like the physical trauma which would result from picking up and violently shaking a newborn.

I'd say you can't make this stuff up, but clearly someone has.

Not just "vaccine-induced scurvy that looks exactly like the physical trauma which would result from picking up and violently shaking a newborn", but vaccine-induced scurvy that has that effect almost instantly -- within a day or two at most.

Vaccine-induced scurvy? You have got to be kidding me.

Sadly, no. Some of the anti-vaxxers have branched into the lucrative field of Professional Witness, testifying in court on behalf of baby batterers. They will explain to the court that the deceased infant's broken ribs and cerebral hemorrhage were caused by a new form of galloping scurvy where whichever vaccine the infant had received had sucked all the vitamin C into another dimension.
It may be that they are sincerely convinced that vaccines must be inflicting *some* form of harm, and unable to find anything else, they have battened onto the cause of infant injury.

Kalokerinos was exploiting the Aborigine population in Australia. They do suffer from dire child-health statistics, and so bad is their access to decent food and health support that I can quite believe that he did encounter cases of scurvy among them. However, instead of doing anything to promote better food, he founded his career on campaigning for them to be deprived of what little public-health access they *were* receiving.
Then there was his AIDS-denialism and his accusations of genocide directed at WHO... If Pegasus wants to rely on the likes of Kalokerinos for moral support, then go for it!

And then, as LW pointed out at #389, there is the starkly racist rhetoric from Pegasus in which African vilagers have "instinct" rather than intelligence.

Now I am waiting for Pegasus to cite Kurtz's anecdote from "Apocalypse Now" -- the story where Viet Cong insurgents cut off the arms of children inoculated for polio -- and support the actions of the apocryphal guerillas.

By herr doktor bimler (not verified) on 20 Mar 2012 #permalink

Prometheus @397

In the OAP hearings, video recorded by the parents clearly showed that autistic behaviors were present before the vaccine(s) in question were given. Why would you imagine that other parents - even mothers - would be exempt from this very common human frailty?

Just to emphasize the point - the parents were so convinced that the pre-vaccination video recording did not show autistic behaviors that they presented it as evidence that their child was "normal" before receiving the vaccination.

By Militant Agnostic (not verified) on 20 Mar 2012 #permalink

They will explain to the court that the deceased infant's broken ribs and cerebral hemorrhage were caused by a new form of galloping scurvy where whichever vaccine the infant had received had sucked all the vitamin C into another dimension.

Hahahaha! Nobody would actually...

...wait...

Oh for crying out loud. A hearty DIAF to all these charlatans.

Do we know if folks like pegasus (and sid, and these other woo charlatans) are as willing to abuse their pets by withholding shots as they are their children, or do they treat animals better?

Prometheus:

"Once again, it needs pointing out that the popularity of an idea is not linked in any way to its validity"

How very, very true. That's the reason why history is replete with examples of the majority being proven wrong, even after hundreds of years.

So, Pegasus, what is your sure fire way to protect babies from pertussis?

Dean, there are as yet no jurisdictions that allow exemptions from rabies vaccines based on religious beliefs. We protect our dogs and cats far better than we do our children, in that regard.

But I'm sure you'll find someone out there who thinks parvo, feline leukemia, etc, can be cured or prevented by woo. I had to leave a room once after a conversation with a woman who was treating her dog's hip dysplasia with acupuncture, lest I slap her into the next dimension.

"How very, very true. That's the reason why history is replete with examples of the majority being proven wrong, even after hundreds of years. "

Yep. Thank you for admitting that when you wrote about an "outcry about vaccinations by an ever-increasing number of lay & professionals" you were committing a fallacy. Of course, without that argument (which you clearly now realize is bogus), you don't have much left, so I look forward to your reconsideration of your entire position.

Pegasus/Emily/D.F. -

Centuries ago evil spirits were blamed for disease. Then we had bad karma. Then it was the humours. Then germs. Then stress. Then genes. Then the ubiquitous claim 'you got a virus'. No wonder Dr Fuhrman titled his second chapter in SuperImmunity " The Failure of Modern Medicine".

But Dr. Fuhrman believes that the flu is a simple viral illness. Is he wrong?

Now I see from the Burzynski link why I am being flatteringly linked to one Emily. Sounded like she spoke sense, although I need to brush up on her natural hygiene.

See, here's another example of your dishonesty. What would you say of someone with an SBM viewpoint who was engaging in lies of this sort?

Give me Dr Wakefield any day over Dr Offitt, the fool who stated that 10,000 vaccinations at once would cause no problems. Does he think everyone is gullible? Then again, he's making millions out of the gullibility, isn't he?

As you observe, we need to evaluate possible biases when there are financial interests involved in promoting a particular health approach. What are your financial interests -- clinic income, seminars, DVD/CD sales, that sort of thing? What, in fact, is your primary source of household income?

As he quotes one of his surgeon colleagues when asked why he doesn't use nutrition to obviate the need for surgery in his patients: "I earn $5 million a year from surgical proceedures, that's why?"

Abba sang about it in the 70's: money, money, money....

...and yet you continue to conceal your financial interest in the therapies you are so vigorously promoting. [Non-]physician, heal thyself.

There is no question that drugs can sometimes save lives.

Please name them.

Sceptics,drug-lovers/nature deniers that you are, just open your eyes to what is going on with the patient results at these [Fuhrman, et al] clinics

It's nice to see that not everyone on this blog is totally closed minded.

You ask people who disagree with you to be open-minded. Yet, you proudly declare that you refuse to act as you ask others to act:

Calling me closed minded you could be right.

Please furnish unambiguous evidence, not that I would attach any significance to it.

Hand washing in a restaurant is a poor analogy. If I want a job there I will comply with the employer's rules, end of story, whatever my views on hand-washing, germ theory etc.

Maggots don't cause the carcass & flies don't cause the garbage & germs don't cause the disease, they FOLLOW it.

I take it that as you believe that germs follow desease, handwashing cannot in any way affect the contracting of disease, correct? Therefore, you believe that handwashing and cleanliness and sanitation have no effect on preventing disease. And, further, that one can contract any disease and the germ may not even be present (if, through some mechanism, it is blocked from contact with the person with the disease), correct?

I believe in Lord Rutherford's statement: that the only pure science is physics, all the rest is stamp collecting.

It follows, therefore, that you admit that the practices you advocate are not based on science.

The public health view indoctrinated into the gullible public that they are powerless against the microbe without public health interventions is what I rail against & rant about.

Your characterization of "the public health view" is false; I suppose you have to falsify it in order to have something to attack (I'm not an expert in debate tactic terminology, but I think this is a form of a strawman argument). The truth is that "the public health view" includes such practices as strict cleanliness and sanitation practices, safe food handling, and so on. It is really disappointing that you must lie to this extent in your efforts to make some sort of impact.

By OccamsLaser (not verified) on 20 Mar 2012 #permalink

Pegasus/Emily/D.F. -

Centuries ago evil spirits were blamed for disease. Then we had bad karma. Then it was the humours. Then germs. Then stress. Then genes. Then the ubiquitous claim 'you got a virus'. No wonder Dr Fuhrman titled his second chapter in SuperImmunity " The Failure of Modern Medicine".

But Dr. Fuhrman believes that the flu is a simple viral illness. Is he wrong?

Now I see from the Burzynski link why I am being flatteringly linked to one Emily. Sounded like she spoke sense, although I need to brush up on her natural hygiene.

See, here's another example of your dishonesty. What would you say of someone with an SBM viewpoint who was engaging in lies of this sort?

Give me Dr Wakefield any day over Dr Offitt, the fool who stated that 10,000 vaccinations at once would cause no problems. Does he think everyone is gullible? Then again, he's making millions out of the gullibility, isn't he?

As you observe, we need to evaluate possible biases when there are financial interests involved in promoting a particular health approach. What are your financial interests -- clinic income, seminars, DVD/CD sales, that sort of thing? What, in fact, is your primary source of household income?

As he quotes one of his surgeon colleagues when asked why he doesn't use nutrition to obviate the need for surgery in his patients: "I earn $5 million a year from surgical proceedures, that's why?"

Abba sang about it in the 70's: money, money, money....

...and yet you continue to conceal your financial interest in the therapies you are so vigorously promoting. [Non-]physician, heal thyself.

There is no question that drugs can sometimes save lives.

Please name them.

Sceptics,drug-lovers/nature deniers that you are, just open your eyes to what is going on with the patient results at these [Fuhrman, et al] clinics

It's nice to see that not everyone on this blog is totally closed minded.

You ask people who disagree with you to be open-minded. Yet, you proudly declare that you refuse to act as you ask others to act:

Calling me closed minded you could be right.

Please furnish unambiguous evidence, not that I would attach any significance to it.

On germ theory:

Hand washing in a restaurant is a poor analogy. If I want a job there I will comply with the employer's rules, end of story, whatever my views on hand-washing, germ theory etc.

Maggots don't cause the carcass & flies don't cause the garbage & germs don't cause the disease, they FOLLOW it.

I take it that as you believe that germs follow desease, handwashing cannot in any way affect the contracting of disease, correct? Therefore, you believe that handwashing and cleanliness and sanitation have no effect on preventing disease. And, further, that one can contract any disease and the germ may not even be present (if, through some mechanism, it is blocked from contact with the person with the disease), correct?

I believe in Lord Rutherford's statement: that the only pure science is physics, all the rest is stamp collecting.

It follows, therefore, that you admit that the practices you advocate are not based on science.

The public health view indoctrinated into the gullible public that they are powerless against the microbe without public health interventions is what I rail against & rant about.

Your characterization of "the public health view" is false; I suppose you have to falsify it in order to have something to attack (I'm not an expert in debate tactic terminology, but I think this is a form of a strawman argument). The truth is that "the public health view" includes such practices as strict cleanliness and sanitation practices, safe food handling, and so on. It is really disappointing that you must lie to this extent in your efforts to make some sort of impact.

By OccamsLaser (not verified) on 20 Mar 2012 #permalink

@379 Adelady

Your comment was wonderful!

@380 Pegasus

As usual the alt-med advocates forget that 'follow the money' works both ways. It's a tactic that I despise from both skeptics and alt-medders, because it proves nothing but that people like to be able to feed themselves, no matter what side of the fence they're on. Earning dough doesn't really say anything of the validity of what they promote.

@385 Pegasus

Many years ago I attended a talk by Dr Archie Kalokerinos, an Australian doctor who was one of the first to link the 3 month triple antigen with SIDS.

Are you Australian? Or American?

Do you people really think that the outcry about vaccinations by an ever-increasing number of lay & professionals alike is because they are morons? They are stupid? Or are they all shit-stirrers, just out to bring down the medical/drug establishment?

I think they are prone to confirmation bias and correlation/causation, like everyone else. The difference is that scientists know about these effects and account for it. Most people don't realise how easy their brains fool them; not so much delusion as honest mistaken beliefs. I have plenty of honest mistaken beliefs, the difference is I don't go around telling everyone to follow my actions.

Why are so many mothers complaining of changes in their babies/children's health & development soon after vaccination?

You're missing an important point here: the scientists listened to the parents, investigated claims, discovered nothing, and then - because of lack of time and funding to investigate everything to the nth degree - moved on to other more plausible areas where they were more likely to find a cure/treatment. You ignore that fact like so many other anti-vaxxers do. In your world, if scientists don't confirm a mistaken belief, well then, they just didn't listen in the first place. In reality, scientists listened, then investigated, then disagreed and moved on. (This ignores another issue which is that anti-vaxxers are just a loud minority and that many autism advocates/autistic people agree with the science)

Why don't we see the same intense sentiment from people concerning other routine medical/ dental procedures eg colonoscopies, teeth braces, mammograms etc? Maybe because there are real & serious adverse effects of this out-of-control vaccination program,that's why.

I'd say it has more to do with the issue of government involvement and school requirements. A certain percentage of people don't want to be told what to do; whereas nobody's legislated everyone have mammograms. I think the vast majority of complaints have more to do with libertarianism than anything else, much like the anti-AGW complaints.

I firmly believe, as do many others, that the vaccine schedule is one of the main causes of the increasing rate of childhood diseases & developmental lags.

That's a fair belief, but when it's investigated and nothing to be found, maybe you should try moving on to other plausible causes where your energy would be better spent.

In my honest opinion, I think it is the worst feature of modern medicine, the full implications of which will unfold in the fullness of time, when the medical profession detaches itself from the drug companies' umbilical cord.

I'd like to know how you would propose doing that. Let's say you are in charge of legislation that would prevent Big Pharma from dealing with doctors... how would you prevent it? How would you ensure full and honest investigation of illnesses, their cures/treatments, and the implementation of it without co-operation or interdependency? I'd really like to know how you would separate them and how you would still ensure people receive good medical assistance when they need it.

Apologies for the duplicate post. Second version is correct.

-OL

By OccamsLaser (not verified) on 20 Mar 2012 #permalink

@ flip:

I'd like to add that while alt medders screech about the filthy lucre doctors and pharma companies extort they sometimes portray themselves as altruistic humanitarians with sundry charities listed amongst their product listings..I mean *informational articles*- and speak about their free counselling sessions and lectures as well as feeding the poor. However, it's easy to figure out how much average doctors earn if you know where they live and pharma companies are usually required to post earnings. Woo-meisters are a bit harder to trace but here's at least one: it's 10-11 million per year ( in AUS$, esp for you!)from supplement sales according to spoke.com and manta.com. Supposedly an alt med fave sought out 40 million per annum ( AUS$) from a new product he'd market. Another owns several companies. A few of our targeted boys have exquisitely posh digs displayed on the net for all to see and infer the cost thereof. No shabby chic here!

Remember these are the same fellows yapping incessantly about *greedy doctors* and *highway robbery* by pharma... what're they jealous?

By Denice Walter (not verified) on 20 Mar 2012 #permalink

Herr Doktor:

"Kalokerinos was exploiting the Aborigine population in Australia. They do suffer from dire child-health statistics, and so bad is their access to decent food and health support that I can quite believe that he did encounter cases of scurvy among them. However, instead of doing anything to promote better food, he founded his career on campaigning for them to be deprived of what little public-health access they *were* receiving".

Nice fabrication. To add weight to your hate,I suppose you'll throw anything at people like Archie even if it's total psychobabble,which this is.

Archie recommended & made changes to the indigenous diet. During his career he strongly advocated a wholesome diet, focussed on vegetable & fruits. I heard him speak a number of times & heard him promote a far better nutrition program than was advocated by the health department at the time (this is not hard to do, even today).

To say he was exploiting the aboriginal community is to inflict harm upon your own cause. He was a remarkable man of courage, compassion & conviction. The more you lie about such a wonderful human, the smaller you & your cause becomes.

Occamslaser/ Amelia/ FW:

Read Fuhrman's books. Especially chapter 2 ( The Failure of Modern Medicine) of his lates book SuperImmunity You might learn something. Then you will know that he was simplifying his views for the average person. It's multi factorial.

Please let me know what you learn from reading his wisdom.

Peg,

Big Pharma! Conspiracies! Yadda yadda.

What about Wakefraud's massive cash bonus for FALSIFYING HIS RESEARCH?

You reckon every doctor is on the take, corrupt, taking backhanders, etc.

Yet when one is proved to have done exactly that, he's your hero!

But hey, who needs logic when you're an anti-vaxxer?

"Then you will know that he was simplifying his views for the average person...."

Nope. He was simplifying them for the simple person.

*waves*

Why don't we see the same intense sentiment from people concerning other routine medical/ dental procedures eg colonoscopies, teeth braces, mammograms etc?

Well, let's see:Braces - there's no legal requirement for braces, nobody cares if you get them or don't, and they serve a largely cosmetic purpose. Braces were even a form of jewelry for a while.Mammograms - I don't know where you were when in 2009 when the U.S. Preventive Services Task Force (USPSTF) updated its guidelines for breast-cancer screening to reduce the recommended frequency. There was some pretty intense sentiment attached to that. It was in all the papers.Colonoscopies - As colon therapies of all kinds seem to be de riguer in alternative medicine, I'm surprised you bring this up. Most people I know who've had one were not impressed, though my friends who had colon cancer are pretty glad they had them.Compare these to mass immunization, which has the potential to save millions of lives and eradicate a number of diseases that kill or maim children - but at some individual risk.

By Mephistopheles… (not verified) on 20 Mar 2012 #permalink

Krebiozen:

"Relman and Angell are criticizing the private insurance healthcare system in America, not the way medicine is practiced".

Your interpretation is certainly sanitised. You must be a very conservative, conventional doctor.

When the FDA is a slave to the drug companies (Angell),& the FDA is all powerful in approving poorly & inadequately tested drugs which are then foisted upon the trusting & innocent pubklic, this changes the way medicine is practiced. Read more from Dr Angell, especially her wonderful book The Truth about the Drug Companies.

Imagine the woo meisters selling their supplements & one of the leaders of woo coming out & openly admitting that the regulatory body of woo was a slave to the supplement industry.

I am covering my ears because of the "irony meters".

Covering your ears, Peg?

Must be some unambiguous evidence around...

(#333)

@416 Denice

A slight side issue to what you're saying and a hamper in Peggy's britches:

Here in Aus the majority of pharmacies carry... yep, you guessed it, alt med products. There's no end of vitamins, supplements and other alt med stuff. And yet, Big Pharma is somehow suppressing it all - and managing to earn a profit from it too.

Must be a great conspiracy when you can walk into your pharmacy and buy any old woo you like.

@417 Pegamily

During his career he strongly advocated a wholesome diet, focussed on vegetable & fruits

I guess Indigenous populations didn't know about those things, having not been living off the land for decades... Got any actual proof for that statement?

@418 Pegamily

Hey, recommendations to read books instead of peer-reviewed literature! I think I need to invent a Pegamily bingo card.

Just like Emily, you're ignoring my hard questions too. What do only the others deserve a (admittedly half-assed) response?

@422 Pegamily

Imagine the woo meisters selling their supplements & one of the leaders of woo coming out & openly admitting that the regulatory body of woo was a slave to the supplement industry.

What regulatory body of woo? There is none. Which is probably the point but not in the way you think.

Thomas @412

Of course, without that argument (which you clearly now realize is bogus), you don't have much left, so I look forward to your reconsideration of your entire position.

Will that reconsideration occur before or after the heat death of the universe?

By Militant Agnostic (not verified) on 20 Mar 2012 #permalink

Mark M:

"Big Pharma! Conspiracies! Yadda yadda.

What about Wakefraud's massive cash bonus for FALSIFYING HIS RESEARCH?

You reckon every doctor is on the take, corrupt, taking backhanders, etc.

Yet when one is proved to have done exactly that, he's your hero!"

Did I say every doctor? Please furnish evidence.Did I say a conspiracy? Ditto. Did I call Wakefield my hero? Never.

The sceptics' ploy: attribute fanciful statements & positions to your opponent, & then clubbers unite. It's very amusing, really.

After reading most of the other threads, past & present, I'm getting a good feel for the commentators with creativity & flair. We'll never agree on anything pertaining to health, mind you, but hey, what's that between friends?

Krebiozen:

American Academy of Orthopaedic Surgeons (AAOS) 2012 Annual Meeting

From Medscape Medical News

Bisphosphonates Increase Contralateral Atypical Fracture Risk

Laird Harrison
February 9, 2012 (San Francisco, California) â Patients who continue bisphosphonate therapy after an atypical index femur fracture are more likely to suffer a fracture in the contralateral femur, researchers reported here at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting.

"Stop bisphosphonates if you have an index atypical fracture," said lead researcher Richard M. Dell, MD, an orthopaedic surgeon at Kaiser Permanente, California.

Increasing evidence shows an association between bisphosphonate use and atypical femur fractures. Previous research found that more than 20% of patients with an index atypical femur fracture will develop an atypical femur fracture on the contralateral femur.

To examine the impact of discontinuing bisphosphonate use in these patients, researchers at Kaiser Permanente in California studied 126 patients who suffered atypical femur fractures at the medical center in 2007, 2008, and 2009. (Kaiser's database was useful because extensive records were available on 2.6 million people older than 45 years.)

The researchers found that 53.8% of those who continued bisphosphonates for 3 or more years after the first atypical fracture suffered an atypical fracture in the contralateral femur.

In contrast, only 18.5% of those who discontinued bisphosphonates in the first few months after the initial fracture experienced a contralateral atypical femur fracture.

In other words, by stopping bisphosphonate therapy, these patients reduced their risk for a contralateral atypical fracture by 65.6% (P = .023).

Bisphosphonates both strengthen and weaken bone by slowing the process of remodeling, he noted. "The bone becomes old, and old bone acquires micro damage," he explained. "Initially, the bone is stronger, but eventually it becomes weaker."

This study adds evidence that this is happening.

"This would argue very strongly that you should discontinue the bisphosphonates" in patients who have been taking them for a long time, Dr. Lane said.

Current US Food and Drug Administration labels call on physicians to consider this possibility in their bisphosphonate prescriptions.

Dr. Lane recommends that patients taking bisphosphonates stop after 5 years. Then he measures bone density and bone markers.

If the bones are dense enough and not being remodeled too fast, the patients can continue without bisphosphonates. If the bones are losing density, he recommends a lower dose.

Dr. Dell recommended discontinuing bisphosphonates in patients whose radiographs show warning signs of atypical fractures. He pointed out that alternative drugs can be used to treat osteoporosis. However, the relation between other antiresorptive drugs and atypical fractures is still not well known, Dr. Lane said.

Dr. Dell has disclosed no relevant financial relationships. Dr. Lane reports relationships with multiple companies that make products for orthopaedic surgery.

American Academy of Orthopaedic Surgeons (AAOS) 2012 Annual Meeting: Abstract 190. Presented February 8, 2012.

Within 10 years, bisphosphonates will follow Vioxx to oblivion. And rightly so.

Just imagine giving literally millions of healthy women chemotherapy, which is what fosomax & other bisphosphonates are. State sanctioned carnage, mainly on women.

It would be worth your while Krebiozen, to keep abreast of the dangers of your profession's drugs, instead of continually spinning the party line how good & safe they are.

Did it ever occur to you that these people (pegasus, emily, etc) only know really bad doctors? I have never been to a doctor who pushed drugs for things that could be controlled by a better diet, exercise, fresh air.

Yes, I take medication for high blood pressure, but before starting the medication, my doctor had done "watchful waiting" while I increased my exercise levels, lost weight, saw a dietician and improved my diet. For 2 years, the evil doctor DEPRIVED Big Pharma of any profits from my taking medications and watching to see if the other treatments would help. Shame on him!

My ex has adult onset diabetes. Again, the evil doctor pushed nutrition, exercise, dietary counseling - though DID start medications right away. However, as my ex lost weight and his blood sugars improved, the medications were decreased in amount and frequency. Why, now he's only taking 1 pill a day! Shameful that Big Pharma is being deprived of the profits from his 3 pills a day beginning dose.

Pegasus: you'd impress us all a lot more if you posted peer-reviewed evidence of your information, didn't cherry-pick data, and didn't accuse others of ad hominums while using them yourself.

Shay @ 410:

Dean, there are as yet no jurisdictions that allow exemptions from rabies vaccines based on religious beliefs. We protect our dogs and cats far better than we do our children, in that regard.

True, however in most jurisdictions, the most enforcement is that the city won't issue a license if you don't submit proof of vaccination. Given that cities which *mandate* dog and cat licensure generally have less than 50% of the pets actually licensed, it's unreasonable to expect vaccine enforcement to be effective. Obviously there are not the resources. From watching Animal Planet's various cop shops, I've learned that generally the penalty for not vaccinating is usually nothing unless your dog bites someone, and then it's either losing the dog for a while as it undergoes quarantine, or euthanasia if an asymptomatic victim declines rabies prophylaxis (since the only guaranteed test for rabies in an asymptomatic animal is examination of brain tissue under a microscope). Some jurisdictions may have a fine, but it won't come into play unless your pet bites someone and it gets reported to the police. Technically, most venues require breeders to vaccinate the animals before sale, but again, enforcement is spotty at best. The almost routine nature of puppy mill busts are evidence that enforcement has a serious uphill battle.

So while there are no *legal* exemptions to rabies and distemper vaccination, in practice is it far easier to not vaccinate your dog than to not vaccinate your child. And the majority of people who do not vaccinate their pets do it not out of anti-vax attitudes but out of "meh" attitudes. It is shocking how many pet owners never bring the animal to a vet.

Pegasus @ 427:

Within 10 years, bisphosphonates will follow Vioxx to oblivion. And rightly so.

You just quoted a doctor discussing responsible use of bisphophonates and fine-tuning of treatment plans and you conclude from this that they should be withdrawn from the market? By this logic, pretty much everything should be withdrawn from the market. Including alternative medicine, food, air, water and sunlight. I'm not sure you're really reading what you're pasting, because it does not support your conclusion.

By Calli Arcale (not verified) on 21 Mar 2012 #permalink

Pegasus,

Bisphosphonates Increase Contralateral Atypical Fracture Risk

You mean this article? I think you missed a bit in your quote, this bit:

The drugs are still worthwhile, Joseph Lane, MD, professor of orthopaedic surgery at Weill Cornell Medical College in New York City, told Medscape Medical News. "For 30 to 50 fractures prevented, there is 1 atypical fracture," he said.

Why didn't you include that part of the article? You quoted all the rest of it and just omitted those two sentences. I call that a despicable bit of editing that was deliberately intended to mislead people reading it. How would you describe it?

Within 10 years, bisphosphonates will follow Vioxx to oblivion. And rightly so.

A 40:1 benefit to risk ratio is unacceptable why exactly?

Just imagine giving literally millions of healthy women chemotherapy, which is what fosomax & other bisphosphonates are. State sanctioned carnage, mainly on women.

How can any sane person possibly conclude that a drug that prevents 40 times as many fractures as it causes is "State sanctioned carnage"?

It would be worth your while Krebiozen, to keep abreast of the dangers of your profession's drugs, instead of continually spinning the party line how good & safe they are.

What a sanctimonious piece of *!%# you are, lecturing me when you have just exposed yourself as being deceitful enough to edit articles to fit your prejudices.

By Krebiozen (not verified) on 21 Mar 2012 #permalink

A comment of mine just went into moderation, pointing out that Pegasus omitted a paragraph from the Medscape article:

The drugs are still worthwhile, Joseph Lane, MD, professor of orthopaedic surgery at Weill Cornell Medical College in New York City, told Medscape Medical News. "For 30 to 50 fractures prevented, there is 1 atypical fracture," he said.

By Krebiozen (not verified) on 21 Mar 2012 #permalink

Pegasus/Emily/D.F. -

Did I call Wakefield my hero? Never.

This pattern of lying is really saddening:

Go the good guys! Can't wait for Wakefield to come up trumps.It's only a matter of time.

And I'm still waiting for you to retract this lie:

I sell NOTHING... THERE IS NO PROFIT!!!

Now this:

The sceptics' ploy: attribute fanciful statements & positions to your opponent, & then clubbers unite. It's very amusing, really.

Recognize this tactic? Here's an example:

Give me Dr Wakefield any day over Dr Offitt, the fool who stated that 10,000 vaccinations at once would cause no problems....10,000 hits of formaldehyde? 10,000 hits of polysorbate 80?

As has been pointed out, this is an instance of you attributing a fanciful statement or position to your opponent, and then attacking that fabricated position. For the record, Dr. Offit was solely discussing the immune system's theoretical maximum capacity to respond to antigens. If you'd read the paper in question, of course, you would have known that, but despite your contant hammering of others to read your favorite authors' works, you (once again) act hypocritically in this regard. The result is that you spread false information, and are called on it.

It is refreshing, however, that you have now agreed that it would be a fanciful position to claim there was any conspiracy involving the pharmaceutical industry, doctors, and health regulators, and that you do not hold that position. Thanks for clarifying your stance on that.

I have posed several questions to you that you have repeatedly evaded. I am surprised that rather than answer them truthfully, you would rather be perceived as dodging them. Can it really be that you have decided that the truthful answers to those questions would be even more damaging to your image than the reputation as an evader you are acquiring?

Dr. Fuhrman says that the flu is a simple viral illness.

Is he wrong?

By OccamsLaser (not verified) on 21 Mar 2012 #permalink

Correction to my last comment, Pegasus also omitted this sentence from the Medscape article:

"The medications are extraordinarily helpful, but you don't need them for a lifetime," he said.

Only the bits that suggest the benefits of bisphosphonates outweigh the risks were cut out. I think that's simply despicable.

By Krebiozen (not verified) on 21 Mar 2012 #permalink

Peg,

I've met some dumb, uneducated people in my time, but you're the only one who's actually proud of it. Are you Amish?

"Did I say every doctor? Please furnish evidence. Did I say a conspiracy? Ditto. Did I call Wakefield my hero? Never."

I wasn't quoting you, I was summarising your position. Do learn to read.

Nope, you didn't actually say those exact words. You didn't say plenty of other words too.

Words like Fraud. Quack. Ignorant. Nonsense. Untrained. Amateur. And as recently discovered with your shameful selective editing: deceitful.

But we can hear them from you nonetheless.

Your hero-worship of Wakefraud is blatant. Hence why you ignore the point about his massive conflict of interest and taking £430,000 from Big Pharma to falsify his research.

Still, 'unambiguous evidence' is only there to be ignored, right? Like the cases of measles with and without Wakefraud's MMR scare: http://www.sciencebasedmedicine.org/index.php/measles/

Pegasus/Emily/D.F. -

Did I say a conspiracy?....
The sceptics' ploy: attribute fanciful statements & positions to your opponent, & then clubbers unite. It's very amusing, really.

Here's the proof you demanded:

western medicine is in bed with big pharma

the drug companies employ the FDA as a "handmaiden".

We will have to wait for SBM to find another mistress who is as cashed up as bigpharma.

Earlier:

I know I do not lie. That is all that matters to me.

It has now been shown that you have lied on multiple occasions.

By OccamsLaser (not verified) on 21 Mar 2012 #permalink

Mark M:

I've met some dumb, uneducated people in my time, but you're the only one who's actually proud of it. Are you Amish?

You slander the Amish. They're not dumb, nor even uneducated, really. They even vaccinate their children.

By Calli Arcale (not verified) on 21 Mar 2012 #permalink

Calli, you're quite right. I withdraw that comment.

Pegasus/Emily/D.F. -

To reinforce Krebiozen's point, here is the actual article that you posted after altering it, with the portions you deleted without any indication put back in place and highlighted in bold.

Why did you cut out those passages?

---

Patients who continue bisphosphonate therapy after an atypical index femur fracture are more likely to suffer a fracture in the contralateral femur, researchers reported here at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting.

"Stop bisphosphonates if you have an index atypical fracture," said lead researcher Richard M. Dell, MD, an orthopaedic surgeon at Kaiser Permanente, California.

Increasing evidence shows an association between bisphosphonate use and atypical femur fractures. Previous research found that more than 20% of patients with an index atypical femur fracture will develop an atypical femur fracture on the contralateral femur.

To examine the impact of discontinuing bisphosphonate use in these patients, researchers at Kaiser Permanente in California studied 126 patients who suffered atypical femur fractures at the medical center in 2007, 2008, and 2009. (Kaiser's database was useful because extensive records were available on 2.6 million people older than 45 years.)

The researchers found that 53.8% of those who continued bisphosphonates for 3 or more years after the first atypical fracture suffered an atypical fracture in the contralateral femur.

In contrast, only 18.5% of those who discontinued bisphosphonates in the first few months after the initial fracture experienced a contralateral atypical femur fracture.

In other words, by stopping bisphosphonate therapy, these patients reduced their risk for a contralateral atypical fracture by 65.6% (P = .023).

The drugs are still worthwhile, Joseph Lane, MD, professor of orthopaedic surgery at Weill Cornell Medical College in New York City, told Medscape Medical News.

"For 30 to 50 fractures prevented, there is 1 atypical fracture," he said.

Bisphosphonates both strengthen and weaken bone by slowing the process of remodeling, he noted. "The bone becomes old, and old bone acquires micro damage," he explained. "Initially, the bone is stronger, but eventually it becomes weaker."

This study adds evidence that this is happening.

"This would argue very strongly that you should discontinue the bisphosphonates" in patients who have been taking them for a long time, Dr. Lane said.

Current US Food and Drug Administration labels call on physicians to consider this possibility in their bisphosphonate prescriptions.

Dr. Lane recommends that patients taking bisphosphonates stop after 5 years. Then he measures bone density and bone markers.

If the bones are dense enough and not being remodeled too fast, the patients can continue without bisphosphonates. If the bones are losing density, he recommends a lower dose.

"The medications are extraordinarily helpful, but you don't need them for a lifetime," he said.

Dr. Dell recommended discontinuing bisphosphonates in patients whose radiographs show warning signs of atypical fractures. He pointed out that alternative drugs can be used to treat osteoporosis. However, the relation between other antiresorptive drugs and atypical fractures is still not well known, Dr. Lane said.

By OccamsLaser (not verified) on 21 Mar 2012 #permalink

OccamsLaser,
Only quoting the most important part of an article is fair enough. Reproducing an entire article but with the most important information removed (risk/benefit ratio in this case) is something else entirely!

By Krebiozen (not verified) on 21 Mar 2012 #permalink

Krebiozen -

Of course, what it means is that at some level, she knows that reality and truth do not support her positions, so she has no choice but to present fabricated or altered information in service to her cognitive dissonance.

But, as she apparently profits off her promotion of these positions, perhaps the seduction of that income stream is so powerful she is willing to engage in these various dishonest behaviors to maintain that income. Perhaps she will reveal her sources of income and clear that up.

It is quite sad for the Natural Hygiene practitioners (if there are others) that so far, Pegasus/Emily has been their lone representative in these forums. For such a vocal proponent to have been so strongly indicted by her own words is gravely damaging to the image of the movement. I wonder if there might be another NH practitioner who would be willing to disavow Pegasus'/Emily's dishonest statements in an effort to distance the discipline from her dishonesty, evasions, hypocrisy, and fabrications.

By OccamsLaser (not verified) on 21 Mar 2012 #permalink

Pegasus:
The sceptics' ploy: attribute fanciful statements & positions to your opponent
But earlier @175:
Dr Offitt, the fool who stated that 10,000 vaccinations at once would cause no problems [...] Then again, he's making millions out of the gullibility, isn't he?

Tendentious hypocrisy from Pegasus? Well cover me with peanut butter and throw me to the labradors!

Nice fabrication. To add weight to your hate,I suppose you'll throw anything at people like Archie even if it's total psychobabble,which this is.

Coming from Pegasus, I assume this is a compliment. But I will not be swayed by flattery! Well maybe a little.

Flip:
Just like Emily, you're ignoring my hard questions too.

That's how the gish-galloping style of trolling works, flip. You can ignore all the refutations of the nonsensical claims comprising your previous comment, because you have already moved on to a new comment and a new list of nonsensical claims cut-&-pasted from elsewhere.
Some of the trolls who frequent RI are classy and it seems a shame to label them and Pegasus with the same term.

By herr doktor bimler (not verified) on 21 Mar 2012 #permalink

@426 Pegamily

Check bingo card - Emily's brush off as disagreements and actual discussion of the issues/questions put to her. (And @427, check bingo card - Emily's misquoting of sources)

@428 MI Dawn

Did it ever occur to you that these people (pegasus, emily, etc) only know really bad doctors?

Yes. In fact, I'd bet that most alt-medders head that way because of bad experiences with certain doctors. (I know it's happened in my family, including myself in my pre-skeptical days)

@435 Occamslaser

Pegasus hero-worships Wakefield, so it's no surprise that she emulates his lying and his denial of it.

@441 Herr Doktor Bimler

Oh I'm quite familiar with Gish gallop; but it does help to point out what she's doing to the lurkers. When I started reading science blogs (not Science Blogs, I just mean science sites in general) the one thing that put me off someone's argument was the refusal to answer questions. If someone is willing to admit problems or discuss the tough stuff, I may disagree with their position, but I gain a respect for their attitude.

Well what a naughty little boy I am. I omitted a couple of paragraphs, & in retrospect I should have included the whole article. I knew the entire article would be read by some of you sceptics, but I didn't think it would incur your wrath like it did.

Of course Dr Dell would justify the chemotherapy to normal women, as he feels compelled to appease his colleagues . And besides, As Dr Strand states in his very honest book Death by Prescription, "doctors love their drugs". Dell's comment is the Allopathic Quack Miranda principle. Gently criticise some aspect of the medical juggernaut, but be sure to issue a sugar coated caveat how much you respect the very thing you're citicising, & how wonderful the drug is.

Bisphosphonates were poorly tested, which we know is usual for most drugs since the FDA sold out for money to "fast track" approvals.

They were initially never intended for healthy women. Now they are used very widely in healthy women, who reperesent a lucrative cash cow to the drug companies, the specialists & the DEXA scan manufacturers (read Selling Sickness by Moynihan). And who suffers? Mainly women. Bone that is osteopenic doesn't need chemo, it needs lifestyle modifications. But common sense & health were never really taught at med school.

The following problems with bisphosphonates have been reported in your medical journals. Read them yourselves, & if you are female, think twice if your good doctor's love affair with drugs is worth the risk, when common-sense lifestyle modifications are all that are needed:

Gastric ulcers: Arch Int. Med Jan 8, 2001;
Serious eye problems: NEJM March 20, 2003;
Atrial fibrillation: Arch Int Med April 28, 2008;
Atypical low energy fractures: NEJM March 20, 2008 & Jnl of Clin Endocrin & Metab. 2005 Vol 90;
Jaw Rot: Jnl Dental Res 2006 No 86; Annals Int Med 2006 No 145; gen Med Jnl Watch March 31 2005; Jnl Am Dental Assn 2006 Vol 137;
Oesophogeal Cancer: NEJM Jan 1 2009.

Do doctors who prescribe chemo to healthy women tell them of these possible side-effects. Rarely, if ever. And it is the women who suffer, just like they did with HRT for 40 years before the drug's long term effects were fully understood. And what happened when HRT was exposed & women stopped taking it? Breast cancer rates fell sharply, according to the Cancer Council of Australia.

And this is just the tip of the iceberg.

How do my sins of omitting 2 paragraphs, which copped your bile, compare to this:

" How did we get here? How did money come to exert such a remarkable influence over the medical profession?" Dr Jerome P Kassirer: "On the Take: How Medicine's Complicity with Big Business Can Endanger Your Health" p170.

About the above book, this is what Dr Jordan Cohen, President, Association of American Colleges says:

" Public outrage at the unconscionable practices documented in this book may be our only hope of redirecting the medical profession away from overweening self- interest & back towards its moral purpose- protecting patients' interests. If readers of this book are not outraged at what they learn, hope for a future of beneficient medicine may indeed be lost" (Back cover of book).

And this: "There are unanswered questions about vaccine safety. We need studies on vaccinated populations based on various schedules & doses as well as individual patient susceptibilities that we are continuing to learn about. No one should be threatened by the ppursuit of this knowledge. Vaccine policy should be the topic of frank & open debate, with no tolerance for bullying." Dr Bernadette Healey, former Director, NIH.

And this from Dr Caldwell Esselstyn in his book 'Prevent & Reverse Heart Disease' p9:

"Modern hospitals offer almost nothing to enhance public health" & then p10 & this is for you MI Dawn::

"As a physician, I am embarrassed by my profession's lack of interest in healthier lifestyles. We need to change the way we approach chronic disease. p10"

Get serious sceptics. You can vent your spleen at me no problem, but wake up to what is happening in modern medicine, it's a looming catastrophe.

And finally Krebiozen, for you to call the deceased Dr Kalokerinos a "raving lunatic" is typical of your morals & ethics. You villify me for an omission (fair enough) but reflexly dismiss people like Archie, Fuhrman & T. Colin Campbell by plucking some nonsense criticism out of the woodwork from your ilk, without knowing much about them or the real subject.Your knowledge of health is no better than the average doctors, which is appalling.There are very few enlightened & brave medical doctors. You certainly aren't one, as you are a toe-the-liner medical/drugs apologist. Kalokerinos was one of them.

Very interesting reading. Could I make a suggestion to you Pegasus.

Forget the alt/medders, forget 90% of SBM (seriously bad medicine) & research the true biological principles of self-healing.

This won't change any of the bloggers' minds or lives, but it will change yours, I promise you.

"Will that reconsideration occur before or after the heat death of the universe?"

Oh, I have faith in Pegasus; I'm sure that the retraction will come, now that Pegasus has recognized the weakness of the evidence he or she presented. Pegasus is far too honest a person to refuse to admit a mistake.

Di I detect some sock-puppetry being used a a pretext for a quick exit?

By Krebiozen (not verified) on 21 Mar 2012 #permalink

"Well what a naughty little boy I am."

See - Pegasus acknowledged lying by omission.

"And finally Krebiozen, for you to call the deceased Dr Kalokerinos a "raving lunatic" is typical of your morals & ethics."

And here Pegasus condemns name-calling, which I assume means that Pegasus is rightfully ashamed of writing
"poison lovers," "fool" "drug-lovers/nature deniers" and all the other name-calling he has done.

Thomas:

The difference is that the object of my scorn is not dead. My omission you can call what you like, but Krebiozen's shot at the deceased is nothing short of a disgrace, & shows him as the low life he is. He should honestly be ashamed of himself. No wonder there is an implosion coming.

Absolutely. Deceptive quotes are much more ethical than insulting dead people. Thanks again for conceding that your appeals to popularity were invalid, by the way.

My omission you can call what you like,

"Willful deception" sounds OK.

but Krebiozen's shot at the deceased apologist for infant-killers

FTFY. I'm sure he was swell otherwise.

is nothing short of a disgrace, & shows him as the low life he is.

Not so low as to misquote and try to paper over it with distractions and idiocies, it seems.

@444 Emily

Wow, we constantly berate Pegasus for being you after a month of silence from your comments... and suddenly you appear again. (Granted I haven't read the last few blog posts, so I may be wrong in my assumption)

Forget the alt/medders, forget 90% of SBM (seriously bad medicine) & research the true biological principles of self-healing.

What was that about not having anything to sell or promote?

This won't change any of the bloggers' minds or lives, but it will change yours, I promise you.

Yeah, you had ample opportunity to change mine, except you were incapable of: making any specific definitions; posting accurate info of sources (some NH) you cited; showing any efficacy or low risk; being honest in general; avoiding reliance on confirmation bias and other logical fallacies.

Tell me, how is sock puppetry done so badly? You showing up here after flouncing off is just bad tactics. Why not just return after a hiatus and say "I had stuff to do, but now I'm ready to get back into the discussion again"? No one would have cared, but the sock puppets make you look even more dishonest (if that's possible) and silly.

@448 Pegamily

The difference is that the object of my scorn is not dead. My omission you can call what you like, but Krebiozen's shot at the deceased is nothing short of a disgrace, & shows him as the low life he is. He should honestly be ashamed of himself. No wonder there is an implosion coming.

Ah I see now. No matter what the person thought or did, if they're dead, they can't be criticised. I call a Godwin looming on the horizon.

Pegasus:

Well what a naughty little boy I am. I omitted a couple of paragraphs, & in retrospect I should have included the whole article. I knew the entire article would be read by some of you sceptics, but I didn't think it would incur your wrath like it did.

Of course Dr Dell would justify the chemotherapy to normal women, as he feels compelled to appease his colleagues .

No, you shouldn't post the entire article; you already posted more than is really polite. But you should probably *read* the whole article. Even what you did quote does not support your conclusion; Dr Dell is not simply sugar coating bisphosphonates to appease the Gods of Pharma. He's discussing fine-tuning of recommendations for a particular subset of the population. You seemed to think he was talking about hidden dangerous that mean nobody at all should be taking them, and it's transparently obvious to anybody with a 10th grade reading comprehension level that that is not what he was saying at all.

By Calli Arcale (not verified) on 21 Mar 2012 #permalink

Pegasus/Emily/D.F./G.F. -

I omitted a couple of paragraphs

We already knew that. But let's be clear: you chose to delete those passages from your posting of the article.

Why did you decide to alter the article by removing those passages? What is your opinion of SBM practitioners who selectively conceal information that does not support their positions?

What is your opinion of yourself?

Please also note that there are several direct questions that have been posed to you repeatedly that you continue to evade, to the detriment of your ever-diminishing reputation.

Your clumsy attempt to bolster your claim that you and "Emily" are two different people who do not know each other can only backfire. I suggest you summon a sliver of integrity, if you have any, throw yourself on the mercy of the readers here, and admit that you have been lying on this point, for whatever reason. I have been very patient with you, but we both know the truth about this. I wonder what honest practitioners of Natural Hygiene think about your antics here on their behalf; when people search for information about Natural Hygiene in the future, they will likely happen upon these threads, and the impression they form will be very unfavorable indeed due to your dishonesty and hypocrisy.

Please tell us what your financial interest is in the approaches to health that you have been promoting. Or would you rather someone else produce that information if you can't be bothered to?

By OccamsLaser (not verified) on 21 Mar 2012 #permalink

Calli Arcale:

"You seemed to think he was talking about hidden dangerous that mean nobody at all should be taking them"

Not at all. These chemotherapy drugs have a limited place in patients with pagets disease & osteosarcoma, & a very small group of patients who have intractable osteoporosis. They are now widely prescribed to normal women, who are increasingly succumbing to the drug's terrible side-effects. Osteopenia is a fabricated disease. What next? Will we be told that sarcopenia is a disease which needs deadly medication? Probably. A little boys being next in line for HPV.

Every major national & international Osteoporosis Society/Foundation, which purport to disseminate objective information to the public, is financially backed by the very companies which stand to profit by hoodwinking the women of the world, with most doctors going along with this travesty.

Who does the medico/pharma complex think are their biggest cash cows? The elderly, the young & women.

Oh look Pegasus/Emily is talking to himself/herself.

Who does the medico/pharma complex think are their biggest cash cows? The elderly, the young & women.

*cough*Viagra*cough*

Good God you are a moron.

Pegasus/Emily/D.F./G.F. -

Please seriously think about confessing your many lies and deceptions in this forum. The self-immolation is becoming uncomfortable to witness.

The falsehoods, hypocricy, fabrications, evasions, purging of statements that undermine your claims, inventing positions of others so you can attack them, concealment of your financial motives -- really, all the most appalling tactics you accuse SBMers of engaging in -- are demolishing your reputation right out in the open for all to see, including your co-workers and family, and likely for all time. You can take the cowardly way out and flee the blog, but it will not matter -- your posts will remain, as will, of course, all the posts by others that expose you. Better to bite the bullet and try to salvage something of your image, if indeed there is anything left.

I daresay that most of the people who you've told us you admire would be deeply embarrassed to be associated with someone who has behaved as you have.

By OccamsLaser (not verified) on 21 Mar 2012 #permalink

"The medications are extraordinarily helpful, but you don't need them for a lifetime," he said.

Wow. You didn't want anyone to see that bit, did you Peggy?

Witness is a liar, case dismissed.

(Cue more quotes from Peggy's paranoid peer-ignored piss-poor paperbacks. 'Death by Prescription' doesn't need censoring, hey Peg...?)

Pegasus,

And finally Krebiozen, for you to call the deceased Dr Kalokerinos a "raving lunatic" is typical of your morals & ethics.

Why is that either immoral or unethical? I chose my words carefully after reading some of Dr. Kalokerinos's articles. Here are some quotes:

My final conclusion after forty years or more in this business is that the unofficial policy of the World Health Organisation and the unofficial policy of âSave the Childrenâs Fund and almost all those organisations is one of murder and genocide. They want to make it appear as if they are saving these kids, but in actual fact they donât. I am talking of those at the very top.

In a talk recorded by Peter Bowditch he said that Hitler and Stalin were like guardian angels compared to these agencies.

During one trial, the prosecution stated that infantile scurvy was no longer seen. I replied with âYes it is. But it is not called âscurvyâ it is called the âshaken baby syndromeâ.

PMID: 15660885 'Could Vitamin C deficiency have a role in shaken baby syndrome?' concludes, "From the available information in the literature, concluded that there was no convincing evidence to conclude that vitamin C deficiency can be considered to be a cause of shaken baby syndrome."

It was similar with the measles vaccination. They went through Africa, South America and elsewhere, and vaccinated sick and starving children...They thought they were wiping out measles, but most of those susceptible to measles died from some other disease that they developed as a result of being vaccinated. The vaccination reduced their immune levels and acted like an infection. Many got septicaemia, gastro-enteritis, etcetera, or made their nutritional status worse and they died from malnutrition. So there were very few susceptible infants left alive to get measles. It's one way to get good statistics, kill all those that are susceptible, which is what they literally did.

I assume he is referring to the high titer measles vaccine which appeared to increase all-cause mortality in some children compared to standard titer measles vaccine. Several studies in developing countries have shown a very large reduction in all-cause mortality in children who were given measles vaccine as compared to those who were not. What Dr. Kalokerinos wrote is demonstrably untrue.

Perhaps I should amend my description of Dr. Kalokerinos. Either he spread what he must have known were lies that would put children's lives at risk, and defended child murderers, or he was delusional, I don't see any other possibility.

By Krebiozen (not verified) on 22 Mar 2012 #permalink

Pegasus,

You villify me for an omission (fair enough) but reflexly dismiss people like Archie, Fuhrman & T. Colin Campbell by plucking some nonsense criticism out of the woodwork from your ilk, without knowing much about them or the real subject.

I have read widely and extensively on the subject with an open mind. When I started taking an interest in nutritional medicine, several years ago (I bought a copy of 'Life Extension' by Pearson and Shaw 25 years ago, which probably shows just how open-minded I used to be), I used to have high hopes that a specific diet, or specific nutrients were the keys to health. After reading umpteen studies, articles and webpages about different diets, nutrients etc. I came to the reluctant conclusion that the maxim "eat, not too much, mostly plants" is all we can say with certainty about nutrition. Pretty much everything else is hype and hot air.

Your gurus don't even agree among themselves what an ideal diet is. Kalokerinos advocated IV vitamin C, Fuhrman promotes a high nutrient to calorie ratio i.e. low starch, and raw foods, McDougall advocates a high starch diet, Campbell claims that animal protein, especially casein, causes heart disease and cancer, Ornish recommends low fat dairy. They can't all be right, unless they are all just reducing calorific intake and increasing consumption of fruit and vegetables, just as my doctor tells me I should. As for "nonsense criticism", you should read the critique of Campbell's China Study that carefully and methodically demonstrates that he cherry-picked the statistics to support his prejudices.

Your knowledge of health is no better than the average doctors, which is appalling.There are very few enlightened & brave medical doctors. You certainly aren't one, as you are a toe-the-liner medical/drugs apologist. Kalokerinos was one of them.

I am not a doctor. You seem to have swallowed whole a lot of claims about diet that are not supported by the evidence, and you are railing against people who are simply less gullible than you. That's how it seems to me anyway. If you really believe that Kalokerinos was enlightened and brave, I don't think we have much left to discuss.

By Krebiozen (not verified) on 22 Mar 2012 #permalink

@455 Pegamily

These chemotherapy drugs have a limited place in patients with pagets disease & osteosarcoma, & a very small group of patients who have intractable osteoporosis.

Check bingo card - Emily's contradictory stance that meds are both evil unnecessaries *and* useful for some medical conditions.

Every major national & international Osteoporosis Society/Foundation, which purport to disseminate objective information to the public, is financially backed by the very companies which stand to profit by hoodwinking the women of the world, with most doctors going along with this travesty.

I return you to my question posed previously: if you were in charge, how would you keep medical practitioners apart from the drug companies, whilst still ensuring good quality and safe treatments/cures for all?

Ah, never mind... I know I'm just being ignored because I called Emily a victim-blamer and blasted her for being a pretty obviously incomprehensible 'pilot' who couldn't answer anything about treating mental illness with her woo. Or anything else for that matter.

A final few words for Pegasus about bisphosphonates. In women who have had a hip fracture (remember that's 329,000 women every year in the US):

Oral bisphosphonate exposure led to relative reduction of 8% per month of use (pâ=â0.001) or about a 60% reduction in mortality per year of use.

Serious fractures occur in a large number of elderly patients. From Medscape:

in 2005, fragility fractures in the USA resulted in 2.5 million medical office visits, 430,000 hospital admissions and 180,000 nursing home admissions, with a direct cost of US$17 billion.

You say that osteopenia is a fabricated disease yet according the the Harvard Women's Health Watch newsletter:

Among postmenopausal women, as many as half of all fractures occur in those whose T-scores don't meet the criteria for full-blown osteoporosis.

Primary prevention of both osteoporosis and fractures is the aim of treating osteopenic women with bisphosphonates. According to Oregon State University:

One out of every two women, and one in eight men over the age of 50 will have an osteoporosis-related fracture in their lifetime.

What was that about "a very small group of patients"?

By Krebiozen (not verified) on 22 Mar 2012 #permalink

Or anything else for that matter.

I ponied up with considerable personal information for her to hypothetically discuss treatment of UTI (a pretty straightforward condition); all she gave in return was chirping crickets, which gives me very little hope for the health of her clients.

By Calli Arcale (not verified) on 22 Mar 2012 #permalink

Krebiozen -- an elderly relative of mine died as a direct consequence of a hip fracture. She was 99, and within months of her centenary. She'd been in pretty good health up to that point, and sharp as a tack. Unfortunately, she did not survive the surgery to repair the hip. That's a common outcome in that age range, but hip fractures are so severely impairing that it's worth the risk of surgery. Better to die under anesthesia on the operating table than after months of bedridden agony.

By Calli Arcale (not verified) on 22 Mar 2012 #permalink

Bisphosphonates were poorly tested, which we know is usual for most drugs since the FDA sold out for money to "fast track" approvals.

If you believe that bisphosphonates were poorly tested, please provide actual evidence the testing was insufficient: tell us what testing should reasonably have been done but was omitted, and/or what testing was done but was done incorrectly.

Waving your hands and chanting "fast track approval" isn't enough--especially as bisphosphonates were approved prior to the inception of the fast track approval process (the first was Merck's Fosamax for treatment of osteoporosis and Paget's disease in September 1994) while the first drug to receive fast track approval was Dupont's Sustiva for treatment of HIV, four years later in September 1998).

FYI, folks... your instincts serve you well.

Moderator confirms Pegasus and Emily do indeed share an IP address. It's the same person.

Bye, bye, Peggemily.

Been nice exposing you.

Calli,

Better to die under anesthesia on the operating table than after months of bedridden agony.

Indeed - mortality within a year after a hip fracture is 15-20%, that's 1 in 4 or 1 in 5 people. Treating elderly osteopenic or osteoporotic women with bisphosphonates carries a tiny risk compared with their benefits. Whether treating osteopenic women is cost effective is a different question.

By Krebiozen (not verified) on 22 Mar 2012 #permalink

@ Krebiozen:

About those *fabricated diseases*:
This has been a popular meme recently *chez woo*- it seems that Pharma and doctors' professional associations meet up and manufacture diseases so that they can sell new drugs to treat the illness thus acquiring customers *for life*!

They dream up symptoms, that are, in reality, just a normal part of living ,"pathologising everyday life", and alert patients to the symptoms and write out rxs. They usually cite restless leg syndrome, acid reflux, sleeping problems as well as many psychological conditions ADHD, GAD, depression.... some of them don't accept the concept of mental illness to *begin with* and rant against psychopharmaceuticals of all stripes. Long diatribes are posted or broadcast implicating meds ( esp SSRIs and atypical anti-psychotics)in school shootings and suicides of young people. Expect to hear lots more along these lines @ NaturalNews and the ProgressiveRadioNetwork.

By Denice Walter (not verified) on 22 Mar 2012 #permalink

Denice,
The same people who complain that SBM does nothing but treat the symptoms get upset when it finds effective ways to prevent symptoms by treating asymptomatic conditions like osteopenia and hyperlipidemia.

As for those who claim that mental illnesses don't exist, they have clearly not had much experience with them. I have had to deal with two close friends developing psychosis; one had late onset schizophrenia, (which resulted in him killing his mother, a tale I have related her before) and one had a depressive psychosis. There was nothing imaginary about either, and neither were using prescription medications.

By Krebiozen (not verified) on 22 Mar 2012 #permalink

@ Krebiozen:

Well, they tend to over-look little complications of daily life like that as well as myocardial infarctions and strokes: remember these are the folks who scoff at vaccines, anti-biotics and ARVs- as if there were never complications of measles and strep or opportunistic infection due to compromised immunity. Those are merely figments of the overly active imaginations of pharma executives, otherwise known as our dearly beloved paymasters.

By Denice Walter (not verified) on 22 Mar 2012 #permalink

Probably. A little boys being next in line for HPV.
The gish-galloping troll's obsessions were becoming a little bit creepy there.

By herr doktor bimler (not verified) on 22 Mar 2012 #permalink

"This has been a popular meme recently *chez woo*- it seems that Pharma and doctors' professional associations meet up and manufacture diseases so that they can sell new drugs to treat the illness thus acquiring customers *for life*!"

It's a wonder then that big pharma hasn't gotten behind Morgellons then, isn't it? I guess doctors and drug companies are evil both when they make up illnesses and when they don't come out with treatments for illness that other people make up.

Don't mention CFS, Thomas, or this thread will keep going with another 473 comments.

By herr doktor bimler (not verified) on 22 Mar 2012 #permalink

Krebiozen:

Your recent response concerning Kalokerinos was measured & appreciated. I can understand how his words would incite
the ire of many, particularly sceptics.

I spoke with him many times, & knew some people who were close to him. I found him a kind & compassionate man, although I didn't personally agree with his extreme views which you have quoted.I did however agree with many other of his views.

Regarding diet, the people you mention agree on most things but differ on a few minor areas. Fuhrman & Campbell also advocate water-only fasting & McDougall refers people to a fasting establishment at times.

The ones you have mentioned (alive) all get fantastic results with many conditions, time & time again. This is because their emphasis is the same, & this is the important thing, not minor differences.

All of them agree that modern medicine is going the wrong way in relation to chronic disease.

I am running, not hiding again & will resume the osteoporosis discussion in future.

'Pegasus' @475

I am running, not hiding again & will resume the osteoporosis discussion in future.

Emily, can you inform us why you decided to use a different name ('Pegasus') when you started posting on this thread? And why you decided to change back to Emily at post 445, then back to Pegasus? This sort of behavior is highly frowned upon here, and is a bannable offense.

@467 Mark M

Moderator confirms Pegasus and Emily do indeed share an IP address. It's the same person.

Well well.... proven a liar once again.

@475 Pegamily

Fuhrman & Campbell also advocate water-only fasting & McDougall refers people to a fasting establishment at times.

Whoops... you nearly slipped into your Emily persona there.

I am running, not hiding again & will resume the osteoporosis discussion in future.

No doubt under a different pseudonym.

Pegasus,

I'm slightly amused that you think me characterising Kalokerinos as a raving lunatic makes me a "lowlife" but you appear happy for me to conclude he was either evil or deluded.

Regarding diet, the people you mention agree on most things but differ on a few minor areas. Fuhrman & Campbell also advocate water-only fasting & McDougall refers people to a fasting establishment at times.

If and when they have accumulated some good quality evidence of the safety and efficacy of fasting, do let me know. I would be interested to see it, honestly. Unlike many CAM interventions it is not entirely implausible that fasting may have benefits over and above a reduction in calorific intake. I will remain sceptical until I see convincing evidence. I suspect the risks outweigh any benefits.

The ones you have mentioned (alive) all get fantastic results with many conditions, time & time again. This is because their emphasis is the same, & this is the important thing, not minor differences.

They claim to get fantastic results, but their publications tell a different story.

All of them agree that modern medicine is going the wrong way in relation to chronic disease.

I think there is a grain of truth in many things you say, but you exaggerate them out of all recognition, and blame modern medicine for what are really social failures, failures of education, or the predictable consequences of putting primates genetically programmed to seek out sweet, fatty foods in an environment where these foods are freely available.

I think that if everyone ate less generally, ate more fruit and vegetables and took more moderate exercise there would be a lot less chronic illness. There is good epidemiological and interventional evidence for this. The difficulty is in getting large numbers of people to make large lifestyle modifications. As I have pointed out before you and your health gurus generally deal with highly motivated people who are willing to make such changes. Even they have compliance problems - Esselstyn's interventional study started with 22 (or possibly 24) patients and after ten years only 6 were still on his diet (PMID 7500065). I have mentioned before the doctor I worked with in a poor part of London who ran a lipid clinic and despaired of getting most of her patients to lose weight and quit smoking.

I think drug companies should be better regulated because, of course, they will exaggerate the safety and efficacy of a drug they have spent hundreds of millions of dollars bringing to market, we know some have been guilty of ignoring evidence of serious side effects of some drugs, and some RCTs that didn't provide the data they wanted have not been published. There are people working on ways of solving these problems, like making sure that all clinical trials are declared before they start and are published whatever they show.

I think that overtreatment and polypharmacy are problems, especially in the elderly, many of whom would benefit from a drug review - pharmacists in the UK have been doing just this recently. If you look on PubMed you will find over 600 studies that have 'polypharmacy' in the title. The systematic medication and assessment review and tracking, the SMART Program, is just one measure being taken to deal with this. I come from a family of doctors and was brought up with the maxim that 90% of complaints that people consult a doctor for will go away on their own, but many of us demand an unnecessary prescription, and doctors too often comply. That is slowly moving in the right direction.

None of this means that SBM is Seriously Bad Medicine, as one of your alter egos claims. It means we need to base more medicine on better evidence.

I am running, not hiding again & will resume the osteoporosis discussion in future.

Unless you find a reliable, effective (meaning it works in the real world), drug-free way of preventing fractures in post-menopausal women that doesn't involve the use of a time-machine, I don't really have anything else to say on the subject.

By Krebiozen (not verified) on 22 Mar 2012 #permalink

Pegasus/Emily/D.F./G.F. -

I am running, not hiding

On the contrary, you have been hiding for a month -- evading direct questions posed to you under your various identities.

For example, you're hiding your financial interests in the health practices you have been pushing, despite multiple requests for that information.

Most of your lies and deceptions have been exposed, despite your efforts to hide them, however.

Do your clients know about your lying? Do you think they will continue to trust you when they discover your true character? Do your business partners advocate the behavior you've engaged in here? Does your family know about this side of you?

Do you sleep well, knowing how dishonest you have been in public?

By OccamsLaser (not verified) on 22 Mar 2012 #permalink

Well well.... proven a liar once again.

Don't forget the casual breathtaking racism... apparently African villagers have "instinct" rather than intelligence.

By herr doktor bimler (not verified) on 22 Mar 2012 #permalink

Krebiozen"

"They claim to get fantastic results, but their publications tell a different story".

Not so. Their publications do nothing of the sort. Their publications support their claims. It's Harriet Hall who tells a different story. But she even says (in relation to The China Study) that they make a good case, just not quite good enough. That's hardly condemnation. And besides, who is she to pontificate about the merits or otherwise of these programs. Her criticisms are totally unconvincing. She also does her cause no good by quoting from the Western Price Foundation for confirmation of her criticisms, the very organisation that your sceptical groups have labelled woo. Even sceptic royalty David Gorsky gently reprimanded her for this in your links.

Don't need to wait 10 years for rct's to prove beyong doubt that their programs are effective in disease prevention/reversal. As Esselstyn says: they work.

Pegasus/Emily/D.F./G.F -

What is your financial interest in the approaches to health that you are promoting?

Will you have the integrity to admit that you've been lying about Pegasus and Emily being two different people?

Will you find the strength to admit that you lied when you wrote, as Pegasus, that you were not up on "Emily's" Natural Hygiene?

Will you confess that you fabricated a claim by Dr. Offitt in order to attack a position that he does not hold?

Will you reveal the reason you selectively removed passages from an article that you posted without giving any indication that you had altered it?

Are you lying to your clients with this regularity? Do you justify your dishonesty by believing you have to do it in order to maintain your income? How do you feel about members of the SBM community who engage in that behavior?

Should we judge the Natural Hygiene field as a whole by your behavior, or if we look for others who make the claims that you do, would we find only you?

By OccamsLaser (not verified) on 23 Mar 2012 #permalink

I'm still waiting for Pegily's special magic diet that will protect a baby from pertussis. She never did satisfactorily tell us why the rates of measles incidence plummeted 90% in the USA between 1960 and 1970.

It is an amusing morphing troll.

Yeah, I'd like Pegamily to answer Chris' question. Of course answering one or more of the others would be nice too.

Occy:

You are tenacious, I'll concede that.

The irony is that you are partly responsible for the morphing. You, supported by another blogger who shall remain pseudonymless, were the ones who became identity obsessed in my previous life & talked in terms of work interference, disclosing phone numbers etc. I didn't mind the verbal abuse ( children who are disease vectors, irresponsible, dangerous parent etc), that was fine, I can give as good as I get. If you recall, I exited because of the slight chance that this vague threat by you & co could escalate into reprisals or something more tragic for my family. I'm not saying you or the other blogger were intending any such radical action, but one must play it safe in this crazy world, guarding against all possibilities.

However,I enjoyed the intellectual jousting, gained from the experience, & after a month on the sidelines just reading the blogs, I decided to slide back into the mix.

I did not fabricate a claim by Dr Offitt. It was my understanding he claimed 10,000 vaccinations would be harmless in one day, I stated that as such, then someone stated his claim was a 10,000 antigen load. No lie, no big deal.

The selective ommission of those passages is the only thing you can fairly charge me with. It was a long piece,so I dumped a couple of segments, leaving the thrust of the piece to more strongly favor my argument. Guilty as charged. A world away from pharma omitting adverse effects from their findings to increase their bottom line, at the expense of countless human lives.

Regarding my income, that is my business. I do not ask you yours. I will say though, that although you classify me as an alt/med purveyer of woo,I am much closer to your philosophy than you really understand. I am highly critical of the nonsense from both sides of the fence. The problem is that the conventional nonsense maims & kills far more people than dispensing diluted water masquerading as a remedy etc. When untold people could be spared just by removing the causes of their illness, I attack the nonsense purveyers. I do not sell herbs, crystals, homeopathy, potions, elixirs etc.

Thanks for enquiring about my sleep. I sleep very well & look forward to each day with optimism & vitality.

So there you have it, Occy. Have a good day.

@Pegamily - I'm glad you finally admitted to lying. Selective omission is still lying, regardless of your vocation.

@485 Pegamily

The irony is that you are partly responsible for the morphing.

Oh please. If you were that insulted by their behaviour, what you do is *not* engage in sock puppetry, but engage in a moral higher road where you don't waste your energy on people whose ethics you don't like. If you're not trying to convince people of anything (which you've denied before) why waste your time coming back under a different pseudonym?

If you recall, I exited because of the slight chance that this vague threat by you & co could escalate into reprisals or something more tragic for my family.

In which case you show your utter idiocy by posting using exactly the same tropes and references and calling yourself out and not knowing how IP addresses work. If you're that threatened by the idea of abuse, then you know what: you stop posting where your identity can be further revealed. Either that or take the threats to your local police and make a complaint. I've actually been threatened (in far more abusive ways) from online personalities, and I can tell you the first thing I did was to *stop* engaging with the person/s and *went to the police* because I was that scared for my life and the lives of my family. Did you do either of those things since you're so very frightened?

The selective ommission of those passages is the only thing you can fairly charge me with.

Then you haven't been reading what you've been posting, nor our replies. Not surprising given your blatant misquoting of everything, including people who promote NH.

Regarding my income, that is my business.

It's not. You previously posted that you teach at universities, that you 'pilot' people, that you run a clinic. If it wasn't our business, why did you tell us already? It's quite clear that you're up to your old tricks again: contradiction after contradiction.

I am highly critical of the nonsense from both sides of the fence.

Except of course, that you're not. You have time and time again promoted CAM ideas whilst attacking SBM, and have not once succinctly defined where you agree with SBM except to contradict yourself on where it is useful and where it is not. (See upthread) One minute it's sometimes useful, the next it's the evil threat of allopathy. Make up your mind.

I do not sell herbs, crystals, homeopathy, potions, elixirs etc.

No, just fasting 'therapies', courses in NH, and generally promoting CAM concepts. No profit motive there *roll eyes*

Oh, and a constant reliance on victim-blaming, energy treatments (you promoted energy treatments for mental illnesses), CAM proponents and anything else that fits your confirmation bias and lack of research.

What you seem to get confused about is that if you don't promote crystals, that somehow means we should overlook the fact that both crystals *and* NH are not evidence-based. Here's a clue: we're interested in what you *are* promoting, not what you *aren't*. So you don't promote crystals so what? You do on the other hand promote an awful lot of stuff that doesn't make sense, contradicts itself, and/or is not shown to have any efficacy or low risk.

You came here to promote NH, so even if you're not earning money from it - which you quite clearly are - you're certainly being dishonest by trying to make yourself appear as some innocent question-asker. You're not. You've made it abundantly clear that you're only interest is to attack SBM and promote NH; to attack vaccines and promote fasting; to attack proper treatments for proper illnesses and promote victim blaming, positive thinking as a cure-all, and an unrealistic ideal of natural health.

You informed us - with no evidence to back you up - that germ theory is wrong, evolution has problems, fasting for 30 days is 'healthy', couldn't explain why a NH facility had no emergency staff on hand at night, couldn't point to any research for NH that showed it worked, couldn't accept that anecdotes mean nothing, misquoted references constantly, relied on authority instead of data, contradicted yourself at every turn, couldn't offer diagnoses or treatment plans based on real life examples, couldn't get the number of your own children straight, wouldn't admit you have biases of your own, told us you take no records, outright told me that I'm mentally ill because I was just a horrible child, refused to see that an attack on SBM is not proof that NH (or anything else) works, and just plainly screwed up wherever you could. In more than one thousand comments, you couldn't describe your own position succinctly; let alone defend it against our questions and criticisms.

(Lurkers can follow past discussions here and here)

You came here for the explicit reason to denounce evidence-based medicine and advocate some vague notion based on 'personal experience' and then expected people here to simply take your word for it - and because someone gave you an excuse to flounce off, you did. Because I highly suspect you realised you were getting trounced.

But thank you so VERY much for actually coming out and admitting you were using a sock puppet. Once again, Queen Emily strikes again and shows herself to be incapable of an honest discussion.

@ Pegamily:

You can't have it both ways!
If you use a pseudo-nym you will protect your privacy *however* if you then link to a website that includes contact information because it is an advertisement for your products and/ or services, you shouldn't complain if people realise who you are!

Many people @ RI use pseudos precisely because they have been harassed in RL by their opponents ( I leave off my second last name). Our esteemed host and a few other regulars have had problems; I know a fellow sued for 13 million USD and another who had interference at work and at home, because they took on a well-known charlatan and an HIV/AIDS denialist (respectively) using their real names.

Do you seriously believe that a commenter might pursue you from across the pond or across the Pacific while leaving a trail here for investigation?

About conflicts of interests: if you support a view ( SBM, alt med, TCM) and you also offer a product or service, I think you should mention it even if you do use a pseudo. ' Hi, my name is Qi and I do accupuncture!"- but if you link to your business site- well, what do you expect!
For the record: I counsel people and make investments( virtually none in pharma)

By Denice Walter (not verified) on 23 Mar 2012 #permalink

However,I enjoyed the intellectual jousting, gained from the experience, & after a month on the sidelines just reading the blogs, I decided to slide back into the mix.

Emily, you have yet to apologize for your behavior in comment 445, where you essentially have a conversation with yourself to make it seem as if there are more individuals who share your opinion than there actually are. This behavior is disingenuous and reprehensible. If you truly assumed a new identity solely because you felt threatened, what could your motivations for comment 445 possibly have been?

Pegamily -

You are now on record admitting that you lied about not being, or knowing, "Emily". You are also now on record, therefore, about lying about being ignorant of Natural Hygiene.

You also admit to altering an article by removing parts that undermine the position that you already decided to hold, presumably so that you could fool others about what the article actually said. This is a heinous form of lying.

These three lies are added to your ever-growing accumulation. Let's review some of the others, not all of which have you confessed to.

You claimed, "I sell NOTHING.", and "THERE IS NO PROFIT!!!" These are lies. In addition to being an unambiguous falsehood, it is, perhaps even more egregiously, an attempt to conceal you financial connection with the therapies you are pushing. How do you feel about SBM practitioners who hide their financial interests in the therapies they promote?

You pretended to be an American. You're not.

You claimed to have both a husband and a wife. One of those claims was a lie.

You lied about how many children you had. When you were caught, you lied about why you'd given conflicting information.

You've made false representations about public health policies in order to attack those fabricated policies.

You lied about your view of Mr. Wakefield.

You lied about whether you believed there were conspiracies in SBM.

You lied about what Dr. Offitt stated, writing, "Give me Dr Wakefield any day over Dr Offitt, the fool who stated that 10,000 vaccinations at once would cause no problems....10,000 hits of formaldehyde? 10,000 hits of polysorbate 80?" in order to fabricate support for your position.

You lied about what Dr. Berwick said regarding 30% of medical spending in order to fabricate support for your position.

Here are some new lies by you:

You, supported by another blogger who shall remain pseudonymless, were the ones who became identity obsessed in my previous life & talked in terms of work interference, disclosing phone numbers etc.

You're lying, as the open record at this site proves. Produce evidence that I "talked in terms of work interference, disclosing phone numbers," or retract this fabrication and apologize for smearing me in this repugnant manner.

You write,

the verbal abuse ( children who are disease vectors, irresponsible, dangerous parent etc)

You're lying. Produce a specific quote where I used any of those terms when characterizing you, or retract this fabricated accusation. How disgraceful of you.

You make reference to

this vague threat by you & co

Another scurrilous lie. Produce evidence of this "threat" by me or retract this accusation.

You now say,

I did not fabricate a claim by Dr Offitt. It was my understanding he claimed 10,000 vaccinations would be harmless in one day, I stated that as such

False. You did not state it as "your understanding" as though you weren't sure. Here's what you actually wrote:

Dr Offitt, the fool who stated that 10,000 vaccinations at once would cause no problems.

...and now you throw in,

then someone stated his claim was a 10,000 antigen load. No lie, no big deal

Really? Why, then, didn't you retract it? Why, in fact, did you instead respond by saying,

Antigen load? Give me a break.

Your parade of lies continues unabated.

If an SBM proponent were exposed as being as dishonest as you merely admit to being, would you believe anything he or she said in support of SBM? What would your opinion of such a person be if he or she were being held up as a trusted source of SBM-promoting information? What would you post here about that person?

If Dr. Offitt concealed his financial connections to therapies he supports and was caught reproducing articles where he had removed sections damaging to his positions, and when asked about Natural Hygiene, he fabricated some shocking statements supposedly made by one of its leading practitioners in order to attack that person, what would you post here about your opinion of Dr. Offitt?

When your patients discover how dishonest you are, will they trust what you tell them?

You write,

Regarding my income, that is my business. I do not ask you yours.

How telling. You are so afraid of your financial interest in the approach you're pushing being known, you resort to this absurd tactic. Do you believe that investigators who publish journal articles should be allowed to conceal their financial connections to the subjects they write about by claiming that their income is their business, and besides, they don't ask their readers where their income comes from? You are constantly hammering the point that SBM parties have financial interests that bias or corrupt them, yet you not only refuse to admit your own, you actually go so far as to lie about them.

You say,

although you classify me as an alt/med purveyer of woo,I am much closer to your philosophy than you really understand.

It is most disturbing to consider the prospect of you attempting to minister to a seriously ill person when you are unable to read the simplest text with comprehension. Produce a quote where I "classified you as an alt/med purveyer [sic] of woo" or where I made any statement of "my philosophy", or retract this baffling statement.

In fact, our philosophies couldn't be farther apart. You believe that once you have settled on a position, or you need to promote something in which you have a concealed financial interest, it is fair for you to engage any tactic, including lying, fabricating evidence, taking both sides of an issue, lying about your opponents' positions, and so on, in order to promote the therapies you're pushing, and you believe it is right to choose to be close-minded so that you are not susceptible to having your stance shifted by exposure to truth. In sum, you are terrified of truth, because of what it might mean for your deeply-held beliefs, so you avoid it, and when you come across it, you change it so it is not so threatening. Through this litany of profoundly dishonest mechanisms, you try to maintain your tenuous grip on the position you are afraid to question.

I believe in the opposite of all those things.

I do not lie.

Yes, you do.

A lot.

By OccamsLaser (not verified) on 23 Mar 2012 #permalink

Just like the lying scum she is, Scumily tries to pretend that someone else is responsible for her wrongdoing. "i was so AFWAID! I had NO CHOICE but to take on a new identity! ... and then come back and launch an offensive out of the blue." Hardly plausible, but even if it were true it wouldn't make your collusion between your "Emily" identity and your "Pegasus" identity anything but stupid dishonest sock-puppeting.

If Pegasus had actually been a separate person, her "it's called 'germ theory' and that means it's unproven" gambit would only be woefully ignorant. However, since Pegasus was actually you, choosing to use that gambit after I and several others explained to you in detail why it is incorrect just makes you lying scum. What, you think honest people arguing in good faith drop out of arguments and come back with sock-puppets so they can present arguments they already know are false? If that's the sort of moral values you instilled in your 3-or-maybe-4 children then it's a miracle if none of them are doing jail time. "Remember, kids, if you get caught doing something wrong, say you didn't know it was wrong and you'll never do it again. And if you get caught a second time when you go back to do the same wrong thing, say that it wasn't you the previous time, it was just someone else who really resembles you."

I used to think, back when you were Emily, that you were "just" thick-headed bordering on delusional. Now you've proven beyond a doubt that you're just a dishonest scuzzball who doesn't give a crap about anything but getting her own way, and thinks it's okay to lie through her teeth to get an advantage, just because she's such a special snowflake, she can't be expected to follow the rules that grown-ups do. Go burn in hell, Scumily.

By Antaeus Feldspar (not verified) on 23 Mar 2012 #permalink

I have a comment in moderation slightly upthread, but it occurs to me while reading this:
scienceblogs.com/gregladen/2012/03/the_demise_of_climate_denialis.php

Is Pegamily Lord Monkton in disguise?

My comment finally appears at #487.

Pegasus,

Not so. Their publications do nothing of the sort. Their publications support their claims.

Which publications are you referring to? Those referred to in the link I gave above are very small, and don't measure whether their programs prevent heart attacks or death. They look at surrogates for these endpoints, such as arterial diameter and changes in cholesterol. The problem with surrogates is that they are not always reliable. For example the drug torcetrapib increases HDL levels and was expected to reduce cardiovascular deaths, but RCTs were dropped when it did the opposite. We really don't know the long-term effects of these programs in large numbers of people.

Even if they are effective, they have serious compliance problems. I already pointed out Esselstyn's 75% dropout rate. Ornish's study started with 48 patients and ended with 20 after 5 years. Really they should have included all the patients they 'intended to treat' whether or not they were able to comply, as drug trials do. An intervention that patients cannot stick with isn't very helpful. Until we see large scale longer term studies I remain sceptical.

It's Harriet Hall who tells a different story. But she even says (in relation to The China Study) that they make a good case, just not quite good enough. That's hardly condemnation.

Where does she say that? The blog post I read said of The China Study, "Critics have questioned whether the data support his conclusions and a re-examination of his raw data found serious flaws in his methodology and his reasoning." I have read the full critique of Campbell that Dr. Hall links to (written by a vegan, by the way) which convinced me that he went into the data looking for evidence that supported his hypotheses, and ignored anything that didn't. That's no way to do science, and no way to find the truth.

And besides, who is she to pontificate about the merits or otherwise of these programs. Her criticisms are totally unconvincing.

They are convincing to me. I have read a lot of of what Dr. Hall has written on this and other subjects and I know she is always careful to back up everything she writes with solid evidence. I will wearily repeat that we know that reducing calorific intake, losing weight and eating more fruit and vegetables is helpful. Whether the more extreme diets promoted by these doctors works any better in the medium to long term remains to be seen. If you want better qualified critics, try these:

Dr. Richard Pasternak, director of preventive cardiology at the Massachusetts General Hospital in Boston said that Dr. Ornish's studies were flawed. ''There's virtually no science here, as far as I can tell,'' Dr. Pasternak said. And Dr. Paul D. Thompson, the director of preventive cardiology at Hartford Hospital in Connecticut, said, ''There does come a point where one starts becoming more of a cheerleader than a scientist.''

You might also read 'Heart 411: The Only Guide To Heart Health You'll Ever Need'. I highly recommend it. It's written by two Cleveland Clinic cardiologists and has an excellent section on how to assess the quality of scientific papers, as well as pretty much everything you could every wish to know about cardiovascular health. They recommend a Mediterranean diet, and write:

There are no magic foods or supplements that can dramatically lower LDL. Your dietary habits should be sensible rather than extreme. We do not recommend highly restrictive diets such as the Ornish, Esselstyn, or Pritikin diets: following these diets is challenging, and ultra-low-fat diets tend to have the unfavorable side effect of lowering levels of HDL, the âgoodâ cholesterol.

I'll take the word of these two experienced cardiologists over a diet guru with an on-line store selling books, supplements and gadgets any day.

She also does her cause no good by quoting from the Western Price Foundation for confirmation of her criticisms,

Not in the article I cited she doesn't (it's Weston not Western BTW). If she was making the point that there are people who claim that diets almost diametrically opposed to the vegan-based ones you support are the healthiest, then I agree with her.

Don't need to wait 10 years for rct's to prove beyong doubt that their programs are effective in disease prevention/reversal. As Esselstyn says: they work.

Maybe they do for some people, or maybe long-term these diets have unfortunate effects that don't show up in the very small studies your gurus have done. For the moment I'm eating as close to a Mediterranean diet as I can, taking moderate daily exercise and getting a bit of fresh air and sunlight whenever I can. There's good evidence for this and it makes me feel good.

By Krebiozen (not verified) on 24 Mar 2012 #permalink