Monday, January 24, 2011

And Now For Something Completely Different!

Cue Sousa’s The Liberty Bell.

I know I promised all of you my further thoughts on the Wakefield affair, and I do promise to deliver. However, over the past week, I have not just been under the weather, but can-barely-crawl-out-of-bed sick. So, that delayed my post mortem a bit, and it is sitting in my journal queue to be released at a later date.

But, I’ve decided to delay my assessment a little bit in light of the fact that a friend was kind enough to send me a copy of Wakefield’s book (thank you VERY much sdtech). I’ve begun reading it, and I thought that it would be a good idea to document my thoughts on the book before releasing my final assessment. Over the next few days, I will release several posts on my viewpoint of Wakefield’s book. I feel that to honestly assess this entire business, I need to objectively review all sides of the story. While I have carefully reviewed Wakefield’s defense, it would be dishonest of me to not read his book in the same objective light that I have tried to look at Deer’s research in.

Furthermore, I find that I lack the stomach anymore for all of the bickering going on between various interested parties in these online autism wars. I’ve come to the conclusion that no matter how much I point out the hypocrisy of all who are hurling stones at each other, nothing I can do or say will prevent them from continuing to do so. And, really, do my insults and sarcastic witticisms do anything to help my son? No.

While I will still post with much of my usual sarcastic banter, I will try to refrain from the out-right insulting rhetoric I have been prone to in the past. Will I still point out inaccuracies and hypocrisies that I find? You betcha! But, I don’t feel as if the insults are productive. Unless the person absolutely deserves it. And I know how some of you enjoy my unique take on many things.

So, short post today while I continue to recover. My comments section shall remain open to all; my previous post triggered some very interesting and polite discussions from everyone, for which I sincerely am thankful to all who posted. Let’s keep this up, shall we?

Until next time.

Saturday, January 15, 2011

An Assessment of the Wakefield Affair, part 1

Some of you may have seen my post on Jenny McCarty’s Huffington Post article and are probably curious why I changed my opinion of Dr. Wakefield. What particular piece of information changed my mind? Well, that is a tough question to answer. I can’t point to one particular thing because the only thing I can go on is the evidence provided.

When I started looking at this, I had to use what information that was available. Admittedly, I am missing one particular piece of information from Dr. Wakefield, and that is his book. I haven’t had the time, or the money, to read this book as of now. Am I going to read it? Yes, I will. But, from what I’ve been able to gather, it is really only a rehash of his defense against Deer’s allegations. To not read Wakefield’s book and look at it with the same objective light as I’ve tried to look at everything else concerning this would be intellectually dishonest.

My evaluation looked at Brian Deer’s BMJ articles, his website, Andrew Wakefield’s defense and those websites that defended him, and finally the GMC transcripts. The transcripts were the most time consuming aspect of this case because it was over 6 million words, and I will admit that some of the things mentioned in there I didn’t completely understand. Maybe it was the language used (I’m only bilingual; I speak American, Texan and a tiny bit of Coon-ass). I’ve spent the past week, both day and night, reading, pondering, evaluating, weighing, and thinking. Sometimes, all night, just laying in bed thinking about it (which is why some of my posts on Jenny’s Huffpo article are so rife with spelling and grammar errors…I’m usually much better about things like that)

I’m not going to lie to you; I’m having a really hard time writing this. I put a little bit down, then have to step away and really think about what I need to say next. Some of my trepidation is knowing that my admission has disappointed many people I consider friends. Some of it is mental exhaustion. Some of it is self evaluation. Some of it is the realization that I don’t really have to try to convince anyone of turning against Andrew Wakefield; I only have to tell you what convinced me.

So, let me start with my thought process. You can see a little of it one of my older posts, which I will leave up. I realized that I had an emotional investment in this issue, and that to truly, objectively, evaluate the evidence, I needed to somehow detach myself from my personal investment and actually LOOK at what was being written. In this case, I tried to evaluate it with the following in mind: Deer was biased against Wakefield; Wakefield was biased for himself; and the GMC is supposed to be an unbiased 3rd party (which, I am quite sure, will be argued against…but for the sake of argument, assume that they are unbiased). This was NOT easy, so bear with me.

Over the next few days (maybe longer considering how long it’s taking me to write this), I will discuss specific items pertaining to the Wakefield affair. This will include several items from each of the above mentioned locations. I will evaluate and weigh each of these items and explain why I think the argument is weak or strong.

What jumped out at me first was the accusation that Brian Deer brought against Wakefield as to a potential motive for the 1998 Lancet paper. Essentially, Deer says that Wakefield manufactured the Lancet paper in order to scare the British parents into taking the separate M M and R vaccines, then he would market his own Transfer Factor as a potential rival for these vaccines. This, to me, was Deer’s weakest argument (and thereby Wakefield’s strongest). Yes, the application for the patent does say that it was a vaccine. However, Wakefield’s defense claims that it wasn’t meant as a rival vaccine because it was mainly to be used as a treatment for Inflammatory Bowel Disease and as a potential prophylaxis for immune-compromised patients (bottom of page one, and top of page 2). I am willing to give Wakefield the benefit of the doubt on this one, because Wakefield’s statement concerning this is corroborated by evidence. However, since Wakefield did not disclose this information when releasing the Lancet article, and in the subsequent media announcement, this is a blatant Conflict of Interest. That is bad, even if you defend Wakefield. This calls his Lancet article into serious question, even before you start looking at the science. The GMC hearings say this:

f. A proposal, dated 4 March 1998 and drafted by Mr 10, was submitted to the Royal Free Hospital School of Medicine in relation to the proposed company,
Admitted and found proved

I realized that I started in the middle, so I had to go all the way back to early 1996, when Deer alleges that Wakefield was approached by Richard Barr. To me, this is one of Deer’s strongest arguments. Barr admits to soliciting Dr. Wakefield in order to provide him with several patients for an then unheard of condition that Barr claims was linked to MMR. Over the course of the research into the ‘98 Lancet article, Wakefield received about $750 thousand dollars (plus expenses) for his work. This was also undisclosed. Not only bad, but REALLY bad. Wakefield’s defense is to claim that he was using this money to pay for a second study that he was doing, though never released. But, even if you believe Wakefield, the fact that he did not disclose this information is a serious COI. The GMC hearings say this:

a. In 1996 you were involved in advising Richard Barr, a solicitor
acting for persons alleged to have suffered harm caused by the
administration of the MMR vaccine, as to the research that would be
required to establish that the vaccine was causing injury,
Admitted and found proved

b. Mr Barr had the benefit of public funding from the Legal Aid
Board in relation to the pursuit of litigation against manufacturers of the
MMR vaccine (“the MMR litigation”),
Admitted and found proved

Ok. I think that’s enough for now. I am going to open up the comments to everyone, even those not normally allowed to comment. I have a stipulation, however. Keep it civil, guys. If the comments get out of hand, you will get one warning. If they continue to get out of hand, I will delete the comment. On the 3rd strike, you will no longer be able to comment.

Tomorrow (maybe) I will continue with my evaluation.

Wednesday, January 12, 2011

Old News is New News, or a Tale of the Tail Wagging the Dog

I promise today that my article will be short. I’ve been swamped at work and working a ton of overtime, so I haven’t had as much time as I’d like to read up on things and comment in my usual sarcastic style.

Brian Deer has just released the 2nd part to his expose on Andrew Wakefield. In it, he discusses how Dr. Wakefield filed for a patent for a Transfer Factor that he (Deer) alleges could be used as an alternative vaccine, and that this is the basis for the 1998 Lancet article. Deer contends that Dr. Wakefield wanted to use his report to discredit faith in the combined MMR vaccine, splitting them up into separate vaccines, so that he could get his own TF on the market and make money off of the royalties.

Also, this just in: The Earth circles the sun; the Earth is not flat; water is wet.

In other words, ladies and gents…nothing new, nothing new to see here, move along.

When first I read the headline, I asked myself “Maybe this will convince me that what everyone is saying about Dr. Wakefield is true.”

Instead I came away decidedly underwhelmed and wondering why, suddenly, this is such a big deal, particularly when this same story has been repeated ad nauseum since Deer stuck his ratty little nose in the dumpster and started crying about the sky falling?

So, I started doing a little reading about this Transfer Factor. From what I can gather, this really started up in February of 1996 at the Royal Free hospital. In June of 1997, Dr. Wakefield filed a patent on behalf of the Royal Free (who was the patent holder)for a transfer factor that would treat the measles illness. What this tells me is that it was to alleviate already existing symptoms. He theorized that it could potentially act as a prophylactic (i.e. preventative measure), but when given leave to test the TF on one of the Lancet children, the treatment was ineffective. So, he stopped pursuing the TF as a viable treatment for Measles. This was before his Lancet study was released in 1998.

Ok, under normal circumstances, anyone reading this would think that this evidence is pretty damning. Until they read the details. The devil is always in the details.

You see, if Dr. Wakefield was going to use his TF as an alternative vaccine and instigated the MMR scare after his Lancet article, then why would he have stopped testing on the TF BEFORE the release of his Article in February 1998. If his TF was viable, he would have continued to test and market it. But it wasn’t. And he knew this before releasing his article.

Perspective time. If his only goal was to make money, and he was formulating an alternative vaccine, and he manufactured a report that said that MMR could cause bowel problems so maybe they should split up the vaccines, then why release the article and have a press conference after he knew that his TF didn’t work?
Again, I cannot say with absolute certainty that Dr. Wakefield is innocent or guilty. I cannot do so without reading all of the evidence. But seeing this calls some of the accusations being hurled at him into serious question.

People new to this discussion are probably thinking the same thing once they start reading the details. Why now? Why is this man being so doggedly attacked? No other medical scandal in history has gotten this type of publicity, not even the Vioxx scandal. So, what is different about this one? Are the medical establishment at pharmaceutical companies really this afraid of one man? And we already know that Brian Deer has a serious vendetta against Dr. Wakefield for some unknown reason. Can we trust that his information is objective and unbiased?

Please don’t take it that I am defending Dr. Wakefield. I’m not. All I am doing is commenting at the oddities in what I have read so far. I am forming MY OWN judgment on what I have read.

I encourage everyone reading this to read the reports. Read Deer’s story. Read Wakefield’s story. Read the GMC hearings. And MAKE A JUDGEMENT FOR YOURSELF! Do NOT let people tell you what you should believe. 

Update: I am currently reading the GMC hearings, and someting jumped out at me. Here it is:

"f. A proposal, dated 4 March 1998 and drafted by Mr 10, was submitted to the Royal Free Hospital School of Medicine in relation to the proposed company,

Admitted and found proved"

So, in simple language, this was submited after the Lancet article submitted on February 28, 1998. My earlier post was in error, and for that I apologize. I shall continue to read the hearings and give my final judgement when I'm done.

Additional update:
According to the patent, the TF was being applied for as an alternative to MMR in (wait for it)

IMMUNO-COMPROMISED PATIENTS!!! Also, it is to be used in those with IBD (Inflammatory Bowel Disease) and Crohn's disease. (Page 1 of the patent at 30-35, and page 2 at 5-10)

"Unfortunately, as I have shown previously in the above mentioned patent application the use of theis vaccine has been shown to be instrumental in development of Crohn's disease and other forms of IBD over the ensuing 30 to 40 years and particularly has been instrumental in a substantial increase of Crohn's disease in children since vaccination was started in 1968.

The Physician is therefore confronted with a difficulty at the individual level in that whereas as a public health measure measles vaccination is called for, it can have unwanted effects in those subjects who are unable to immunological eliminate the virus so introduced.

This is particularly so when there is at present no cure for IBD; sufferers can expect relapses of their disease requiring potent immunosuppresant therapy or removal of the affected bowel and may be condemned to the use of a osteomomy bag.

What is needed therefore is a safer vaccine which does not give rise to these problems, and a treatment for those with existing IBD."

Emphasis mine.

Further reading of the patent clearly states that the TF could, in no way, compete with the MMR vaccine. It was simply a proposed alternative protective agent for Measles in those who through whatever reason were not able to get the MMR vaccine. Interesting that all of that information wasn't even touched upon by Brian Deer and his defenders.

So, again I ask; if the TF wasn't a viable protective agent, and it was mainly for treatment and as a potential protective agent in immuno-compromised individuals, then who could it compete with MMR?

Thursday, January 6, 2011

New News is Old News and Anecdotal Hypocrisy

Today I glanced at Orac’s cesspool of lies and misinformation and saw something interesting. Apparently, Wakefield’s 1998 Lancet study was found to be fraudulent. The RID (Ridicule/Ignore/Deny) movement is up in arms, celebrating the downfall of their most despised foe. This is new and breaking News…wait a second. Why do I get such a strong feeling of Déjà vu?

Out of the blue, Brian Deer yells “Wakefield is a Fraud!”

The same thing he yelled in 2004…and 2005…and on up to 2010. Why is this news again?

Orac and his mindless mob of mumbling meatheads think that this is huge. They think that because Brian Deer, a journalist who is not scientifically trained, says that his analysis of the medical records of the Lancet children is true, then it must be true!

Now, before I begin, I must make a confession. I don’t know as much as I’d like about the Lancet study and the resulting scandal. Honestly, it has been something I’ve been meaning to get around to looking at, but just haven’t had the time. I also haven’t read Wakefield’s book, though I would like to. Again, it all falls down to lack of time. So, I will refrain from certain specifics about the study and the children within the study and stick with what I know about this case.

MSNBC headlines are emblazed upon the interwebz with the cry of “First Study to link Vaccines and Autism Declared a Fraud!”

Orac croons over at his Sewer that Wakefield’s fraud was “worse than previously thought.” Josephius at Huffington Post crows that he told us so. To them, this is not about children or health or protecting the herd; it’s about being right.

This all stems from a report by the journalist who originally brought charges against Dr. Wakefield and who went to the GMC council in England concerning this.

Is Wakefield guilty of fraud? Maybe. I don’t know, to be honest, because I haven’t read everything concerning this. When I do get the opportunity to read through the details, I’ll make my own judgment instead of letting someone else tell me what I should think…you know, like Orac tells his lickspittles to do?

What I do know is this. Going from Deer’s article, apparently he approached one of the parents of the Lancet 12 and found some pretty damning “evidence.” But, no one has verified this evidence. They are going off of Brian Deer’s word, and as we all know, he is perfectly unbiased and without conflict of interest considering he is being paid by a member of the board of directors for Glaxo Smith Kline, the company who made the MMR vaccine that Wakefield’s report questioned. You see, anecdotes like this are ok as long as it defends their paradigm.

Another thing. Looking at the MSNBC article, I notice a couple of glaring errors. This wasn’t a study; it was a case report. And, apparently both MSNBC and Orac failed to actually READ the report. Why do I say this, you ask?

Let’s look at what’s being said here:

From MSNBC, “First Study to link Vaccines and Autism Declared a Fraud!”

King Idiot also parrots this by-line, claiming that the report, not study, linked vaccines and autism.

What does the study say, though?

From the conclusion: “We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described (p.164)”

Wait a second! The media is attacking Wakefield for fabricating a report, not study, about a link between vaccines and autism that didn’t actually link vaccines and autism?

Are we confused yet?

Brian Deer carefully analyzed the medical reports of the Lancet 12 and, with his extensive medical training, determined that the data was a fraud.

Now, my dear readers (no pun intended), take the time to consider what is wrong with my previous statement. Both the obvious and not-so-obvious.

Right…Deer is a journalist, not a scientist. And secondly…how was he able to get access to and report on confidential medical records belonging to children below the age of consent, i.e. minors?

Isn’t that illegal? Isn’t that a breach of journalistic integrity and a glaring example of professional misconduct?

So, Deer, the journalist (not scientist) declares that his expert analysis of the medical records of children that he somehow had access to (despite laws that prevent such things) contradicts the findings of Wakefield’s report (not study) that linked a vaccine (made by a company that his boss is on the board of directors of) with the childhood condition known as autism (but actually didn’t link the vaccine to said autism).

I know…hard to follow, huh? It gets better.

You see, none, not one, of the parents of the Lancet children has come forth to corroborate Deer’s claims. In fact, almost all of them defend Dr. Wakefield!

But, we should take Brian Deer’s word for it. Yes we should! The same Brian Deer who stood on national TV, looking at the picture a mother was holding up of her son, who was wearing a colostomy bag after having part of his bowel removed due to bowel disease, and arrogantly declaring with his expert opinion, “That’s not Bowel Disease; that’s diarrhea!”

Seems reliable, yes?

You know, this reminds me of the trial and media blitz about the Doctor who, by signing off on ghost written articles, killed tens of thousands of people by faking the data on the safety of Merck’s Vioxx. Anyone know his name? Can anyone find any articles about this?

Strange, huh?

Continuing the theme of accepting anecdote as evidence when it defends paradigms (you know, what Orac and his doltish clowns laugh at people like me about), I thought I would bring up an interesting exchange I saw recently at Orac’s Brothel.

In his article discussing Dr. Offit’s new book, a discussion took place about the alleged death threats against Dr. Offit. In it, a series of searches and links were provided, and then someone anonymously chimes in;

“I hate to side with STY and Say What here, but the google search you provided are all links to anecdotes. All we have to go on Dr. Offit's word, and that is just hear-say.”

Now, the two he/she mentioned were essentially trolls, and from the tone of his/her comment, he/she was only agreeing that the claims from Offit were anecdotal. But, then, he/she is vehemently attacked for saying that without proof, these claims weren’t evidence.

Ah, the irony is rich!

I love it when they turn on one of their own.