Monday, July 09, 2007

Wakefield and Why The Edith Piaf Routine Is Baseless: Part 2

Piaf: 2 classic images, one of the chanteuse, the other the iconic back view of La vie en rose

Over on Scienceblogs, the brothers Hoofnagle write an extraordinary and thought-provoking blog: Denialism. They caution that we should never mistake denialism for debate:
Denialism is the employment of rhetorical tactics to give the appearance of argument or legitimate debate, when in actuality there is none. These false arguments are used when one has few or no facts to support one's viewpoint against a scientific consensus or against overwhelming evidence to the contrary. They are effective in distracting from actual useful debate using emotionally appealing, but ultimately empty and illogical assertions...

5 general tactics are used by denialists to sow confusion. They are conspiracy, selectivity (cherry-picking), fake experts, impossible expectations (also known as moving goalposts), and general fallacies of logic.
Denialism is a useful way of looking at Wakefield's latest foray into public awareness that was so over-faciliatated by the Observer.
My concern is that it’s biologically plausible that the MMR vaccine causes or contributes to the disease in many children, and that nothing in the science so far dissuades me from the continued need to pursue that question’, Wakefield said. ‘The trend in autism has gone up sharply in many countries. It’s interesting that that increase coincides in many places with the introduction of the MMR vaccine. That doesn’t make it the cause. But it’s an observation that needs to be explained, because there was clearly some environmental change at that time that led to growing numbers of children becoming autistic. It’s a legitimate question if MMR is one of those factors. I fear that it may be.’
Whatever Wakefield professes to fear, it should not be that he discovered a plausible biological link between MMR and autism. Reputable scientists in reputable labs with functioning equipment and good routines in place for running standard controls have not replicated his work. Anthony Cox provides an elegant summary of why Virological evidence does not support a link between MMR vaccine and autism. Wakefield would know this from the reputable literature, unless, of course, he is cherry-picking and relying upon other literature; the sort of literature that doesn't appear in indexed journals or wasn't published after peer-review or with sufficient detail to allow adequate assessment. There is no reputable support for Wakefield's claims of an MMR-vaccine-autism link.

Those trends might sound as if they are plausible enough that someone should investigate them. A number of very well qualified people have carried out these investigations. I will defer to the learned testimony of Dr. Fombonne during the recent Autism Omnibus Hearings. There is no trend of the sort that Wakefield describes. Wakefield is aware of a relevant finding in Japan. Japan abandoned the MMR individual vaccines instead - which is what some campaigners have called for in the UK - yet the rate of diagnosis for autism continues to rise in Japan. Why didn't Campbell ask him about this? Did he not know about Fombonne's testimony (although it is readily available and very readable)? Did he not know about the research that Fombonne had published: Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations?
The findings ruled out an association between pervasive developmental disorder and either high levels of ethylmercury exposure comparable with those experienced in the United States in the 1990s or 1- or 2-dose measles-mumps-rubella vaccinations.
Or closer at home in the UK, in Stafford? Did Campbell not consult Entrez Pubmed for some of the relevant epidemiological studies?

It's obvious that we have some aspects of denialism, but what about the others? I may address some of the others in later posts. For now, I will touch (lightly) on the topic of conspiracy theories because I came across an excellent comment. It seems that Wakefield's friends:
say that he views the GMC hearing as part of a long-running 'Stalinist' campaign to ruin his reputation.
Over on Autism Diva, Matt provides the drollest comment that I've seen on this matter:
the similarities to Stalinist justice are striking. Let's say Wakefield had raised a public health scare in Stalinist USSR. Let's say he had concealed data, and that people had died of preventable diseases.

You could count on the Stalinist courts waiting 10 years, giving him time to mount a defence. You could count on Stalinist judges being limited to removing his right to practice medicine in the USSR. In the end, his punishment would have been the same--banishment to the US where he would be forced to set up a clinic and accept a large salary.

Yep, the similarities are striking.
Wakefield is certainly living La vie en rose if he thinks that the GMC's actions are stalinist. Maybe Wakefield should consider touring with his Edith Piaf, "I have no regrets" routine; it obviously knocked Campbell senseless. Luckily, the Press Complaints Commission has a handy guide to making a complaint. To paraphrase a characteristially astute remark by Anthony Cox about the Japan study:
The BBC and other mainstream media wouldn’t give the time of day to flat earthers, or Holocaust deniers. With the weight of evidence we have now on MMR, it’s time that they stopped giving a platform to the cult of MMR-vaccines-maybe-mercury-autism.

Blog reactions:
Ben Goldacre of Bad Science: Try Me, Sh*thead - the strange case of Carol Stott, Wakefield and the Observer
Dr Crippen of NHS Blog Doctor: Andrew Wakefield, MMR, Autism and the GMC
Tony Hatfield of Retired Ramblings: What the Observer's MMR Piece Didn't Tell You!
Tim Worstall: Crap Reporting in the Observer
Anthony Cox: New Autism Fears, A Man in Denial and MMR Memes in Newspapers
Mike Stanton: Cry Shame on Wakefield and MMR
Kristina Chew of Autism Vox: 1 in 58
Ms Clark of Autism Diva: Embattled Andy Wakefield Speaks and Wakefield and Walker-Smith: Dishonest and Irresponsible
Russell Brown of Public Address: Bad journalism, old stories
Wakefield and Why the Edith Piaf Routines is Baseless: Part 1
Patrick Holford and Andrew Wakefield

Related posts or relevant reading

Dr Michael Fitzpatrick on Stephen Bustin's devastating testimony and why there is nothing in the MMR-autism theory
Brian Deer for a very readable summary of The MMR-autism scare and Wakefield's role in it.
Brian Deer on Prof. John Walker-Smith and his involvement in experimentation on children with autism symptoms and his statement relating to the revelations about the Lancet paper.
Brian Deer on Prof Simon Murch and his involvement with the studies and his defence of the Wakefield research. Brian Deer has performed a thorough analysis of the differences between that statement and the claims made in the Lancet paper
Daily Telegraph on Prof Murch and his statement that there is no link between MMR and autism
Brian Deer has made available an easy-to-read format of the cross-examination of Dr. Arthur Krigsman in the Cedillo case of the Autism Omnibus.
Anthony Cox of Black Triangle: Virological evidence does not support a link between MMR vaccine and autism
Andrew Wakefield, Chronology and "Bad Science"
Patrick Holford and Dr Andrew Wakefield's Discredited Findings: Part 1 and Part 2
Wakefield's Latest Tent Mission on the Doctrine of Autism
Kevin Leitch on Andrew Wakefield and the death of the MMR debacle
Patrick Holford, MMR and What Passes for Hard Evidence
Mike Stanton on Patrick Holford and his unusual views on vaccination, MMR and autism
Patrick Holford Claims Remarkable Benefits for Homeopathic Vaccinations
Holford Watch: Holford believes Secretin is "Worth considering" as an autism treatment; however, there is no evidence that this treatment is effective and
Holford is sceptical about off-label prescribing, but thinks that secretin for autism is "Worth considering"

Flickr credits for the images. 1. edith_piaf, 2. La Vie En Rose

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