Thursday, 6 January 2011

BMJ: Wakefield is a fraud

In a stunning article in the British Medical Journal we are told that Andrew Wakefield, possibly the principal cause of the recent vaccines-are-evil-hype, is even less trustworthy than we discovered before.

Of course, who but Orac is on the prowl:
The discrepancies between the case reports as described in Wakefield's Lancet paper and the actual medical records are anything but random; all are in the direction of suggesting a link between the MMR and Wakefield's as yet unverified syndrome of regressive autism and enterocolitis. The cases that were selected appear not to have been random, sequential patients but were rather recruited specifically through anti-vaccine activists and trial lawyers.
There is no innocent explanation possible for the systematic and numerous discrepancies between the medical record and Wakefield's paper, as the editors of the BMJ point out in their accompanying editorial:
The Office of Research Integrity in the United States defines fraud as fabrication, falsification, or plagiarism. Deer unearthed clear evidence of falsification. He found that not one of the 12 cases reported in the 1998 Lancet paper was free of misrepresentation or undisclosed alteration, and that in no single case could the medical records be fully reconciled with the descriptions, diagnoses, or histories published in the journal. 
Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children's cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross.
Wakefield continues to deny that he has done anything at all wrong and blames the criticisms leveled against him on conspiracies. In reality, given the way the anti-vaccine movement has begun to circle the wagons to defend Wakefield yet again, it's tempting to claim that this is a conspiracy.
In his analysis Brian Deer likens this fraud in scope to Piltdown Man. The next commentator is Phil Plait who writes:
Brian Deer, an investigative journalist, has written a multi-part series on the BMJ site which slams Wakefield. Fiona Godlee, BMJ’s editor-in-chief, also writes about this… and just to be clear, she uses the word "fraud" nine times in her editorial. Not surprisingly, it’s been picked up by several news outlets like CNN, MSNBC, and ABC.
His conclusion:
Andrew Wakefield may not have started the antivax movement, but he certainly egged it on very strongly, along with such mouthpieces as Jenny McCarthy, and Meryl Dorey and the AVN in Australia. If the charges of fraud can be made to stick, then we might be able to make some progress toward reality once again, and lower the rate of outbreaks of measles, pertussis, and polio… and save a lot of lives in the process.
This is exactly why I am not opposed to accountability for willfully endangering other people by invoking free speech. More on the BMJ story by both Pharyngula, Deltoid, and Jeffrey H. Toney.

In the past I have wondered why people adhere to a worldview that has been thoroughly discredited. My unscientific opinion was that it must be some form of delusional disorder. Later, I noted the cognitive dissonance which has been shown to explain such behaviour. In light of what the BMJ has just made public one would hope the infectious-disease-promotion-movement will lose members. Unfortunately, being a cynic, I doubt that will happen.

Update: Be sure to read this too.

Update II: A roundup of responses to the BMJ article is provided by Liz Ditz. The Autism Blog discusses the alleged replication of Wakefield's results: it does not exist. In Scientific American David Ropeik explains that there is a discrepancy between the perceived and factual risk:
Sometimes we’re more afraid than the facts say we need to be (vaccines). With many of the bigger threats, we’re not afraid enough (infectious disease). The gap between our fears and the facts can be dangerous all by itself. Just ask the parents of the thousands of kids worldwide now getting, or dying of diseases that vaccines had pretty much controlled.
The harm he [Wakefield] and others have done will persist for a long time…and will continue to serve as a reminder of the risk we face if we don’t recognize that the way we perceive risk can be a huge risk in and of itself.
The danger of the infectious-disease-promotion-movement is shown by Maryn McKenna who contracted whooping cough in India and wrote an article in Wired about the rise in cases. Take home message:
The worst news in this upsetting trend is this: We’re doing it to ourselves. As far as anyone can tell, the rise in pertussis is not due to any change in the organism, or to any mysterious error among the manufacturers who make pertussis vaccines. It’s due to vaccine refusal, to parents turning away from vaccines because they think the vaccines are more harmful than the diseases they prevent — or, more selfishly, because they think the wall of immunity created by other vaccinated children will protect their unimmunized ones.
Grant Jacobs, for Code for Life, made an overview, and Skepacabra did the same. Nice review of communication pitfalls by The Thoughtful Animal:
Giving us incidence and death rates and other such statistics doesn't really get the job done. It doesn't communicate what they want it to. Nor will glossy pamphlets (like the one they gave me) featuring Mia Hamm telling us to get vaccinated. What will get the job done is story-telling, appealing to emotion, and utilizing accessible analogies. Instead of telling us how many gazillions died last year, tell us how many airplanes full of people, or how many football stadiums full of people died last year.
Update III: Luckily Jenny McCarthy comes to our recsue and rehashes long ago refuted non-arguments. Apparently, true or false is determined by the number of times you make a claim.

1 comment:

  1. I'm keeping a list of positive responses to the BMJ (Yes Wakefield is a fraud, and here are the implications...) and negative responses (Wakefield's research IS TOO valid and vaccines cause autism anyway) at A roundup of responses to the BJM & Wakefield's research was motivated by fraud.

    Some observations
    1. The positive responses come from a broad range of sites -- politically left and right; people who are skeptics/ people who have heretofore (to my knowledge) never commented on vaccines or autism before, and so on. The negative responses are from a predictable set of sites and people.
    2. The news coverage in the US has (perhaps inadvertently) perpetrated the idea that all parents of children with autism believe in the vaccine causation myth. It is a complete falsehood. Many parents of children with autism and adults with autism robustly reject the myth.
    3. Kev Leitch, whose daughter has intense autism, has a moving post on how Wakefield's actions have damaged everyone affected by autism