Thursday, February 12, 2009

Federal court vaccine ruling was very science based

These Wall Street Journal health blog excerpts make it clear that the decision Federal vaccine court special masters was very clear cut. This was not a hard call, the scientific evidence is overwhelmingly against the vaccine-autism beliefs (emphases mine):

WSJ Health Blog : What the Court Said In the Autism Vaccine Cases

One ruling:

After careful consideration of all of the evidence, it was abundantly clear that petitioners’ theories of causation were speculative and unpersuasive. Respondent’s experts were far more qualified, better supported by the weight of scientific research and authority, and simply more persuasive on nearly every point in contention.

A second:

I concluded that the evidence was overwhelmingly contrary to the petitioners’ contentions. … The numerous medical studies concerning these issues, performed by medical scientists worldwide, have come down strongly against the petitioners’ contentions.

A third:

[P]etitioners’ experts tended to assign greater weight to speculative conclusions offered by the investigators involved in the studies than did the investigators themselves. Petitioners’ experts also urged reliance on a few carefully selected sentences from particular articles which, when considered in the proper context of the referenced articles, did not support the propositions advanced by the witnesses. Moreover, because petitioners’ experts relied on a number of scientifically flawed or unreliable articles for several important aspects of their causation theory, their testimony on those aspects of their offered theory could not be credited as sound or reliable. Finally, petitioners’ experts made several key acknowledgments during testimony that rendered their proposed theory of vaccine causation much less than likely.

The third opinion emphasizes that the petitioner's own experts, under examination, contradicted the belief that autism arises from immunization.

This won't be the end of the autism-vaccine meme of course. It long ago became a matter of quasi-religious belief rather than something amenable to data or reason. It will, however, make it very hard to press these arguments in the court system. It's not the judgments alone, it's the ferocity and clarity of the opinions that will make a difference going forward.

Update 9/20/09: Good f/u article on the decision. My favorite line:

... Among those expressing shock and disappointment was Rebecca Estepp, the mother of an autistic child, who is one of the claimants and the national manager of the advocacy group Talk About Curing Autism. "It's tough when you're taking parent support calls and you hear the same story day after day," she told the Wall Street Journal. "When does anecdotal evidence become enough?"

Her question isn't a new one, especially in a society where belief, emotion and science so often conflict. For scientists, the answer to Estepp's question is never.

Thousands of years of anecdotal stories about witches causing disease didn't make it true.

Sunday, February 08, 2009

Vaccines and autism - a fraud from day one?

My distress at the Autism Society of America's vaccine obsession doesn't mean that it was necessarily always a bad idea to look for a link between immunization and autism. A legitimate study showing a correlation would deserve investigation, and when the correlation was disproved it would then be appropriate to move on (years ago, in this case).

Happens all the time. That's science.

But what if there never was a correlation to begin with? That would be one of the most harmful cases of scientific fraud in the past fifty years (emphases mine) ...
Aetiology: Vaccines and autism--can we stick a fork in it now, please?

Last fall, I wrote about a new research paper which tried to replicate some of Andrew Wakefield's original results, which not only claimed a correlation between MMR vaccination and autism, but also the presence of measles virus in intestinal tissue. Wakefield had suggested that an inappropriate response to the presence of measles virus in this tissue may trigger conditions such as bowel disease and autism. The more recent study was unable to replicate any of Wakefield's findings--not surprising, since so many papers in the last decade have found no connection between vaccination and autism.

There are plenty of reasons why the study may not have been replicated. The design of the new study was a bit different from Wakefield's (case-control versus a case series); it had larger numbers; investigators were blinded to the status of the patients and so less likely to bring in bias. However, a recent investigation by the Sunday Times (London) has another reason why the results of the two papers differ: Wakefield made up his data. More after the jump...

From the Times Online:

Confidential medical documents and interviews with witnesses have established that Andrew Wakefield manipulated patients' data, which triggered fears that the MMR triple vaccine to protect against measles, mumps and rubella was linked to the condition.

The research was published in February 1998 in an article in The Lancet medical journal. It claimed that the families of eight out of 12 children attending a routine clinic at the hospital had blamed MMR for their autism, and said that problems came on within days of the jab. The team also claimed to have discovered a new inflammatory bowel disease underlying the children's conditions.

However, our investigation, confirmed by evidence presented to the General Medical Council (GMC), reveals that: In most of the 12 cases, the children's ailments as described in The Lancet were different from their hospital and GP records. Although the research paper claimed that problems came on within days of the jab, in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated. Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal.

This is truly incredible. Even being familiar with Wakefield's statements over the past decade about his research, and his complete denial about studies that have contradicted his own findings, it's still pretty shocking that he completely made up data, and then pushed it for ten years as children around the world became ill and even died in light of his research. It's even more disgusting in light of the fact that I doubt this new information will change many minds when it comes to vaccination--the meme has already spread too far to let a little thing like atrocious scientific misconduct rein it in now.

Wakefield's original Lancet coauthors retracted their interpretation of the data in 2004. The wikipedia article on Wakefield (reads like it's in an edit war) says his research misconduct trial was to commence a year ago, but it seems like this Feb release from the Times of London is the most definitive response thus far.

If the charges are corect, then was Wakefield delusional himself, or is he a sociopath? I'm hoping the former, it's not all that rare in science, but given his subsequent career I fear the latter.

Update 2/9/09: Excellent summary of reactions to the Times article. I scanned some of the skeptics responses, and this is also a list of interesting blogs to consider reading.