Monday, February 6, 2012

Andrew Wakefield

"From the information you provided me on our son, who I was shocked to hear had been included in their published study," he wrote to me, after we met again in California, "the data clearly appeared to be distorted."
No, that can't be!
The Lancet paper was a case series of 12 child patients; it reported a proposed "new syndrome" of enterocolitis and regressive autism and associated this with MMR as an "apparent precipitating event." But in fact:
  • Three of nine children reported with regressive autism did not have autism diagnosed at all. Only one child clearly had regressive autism
  • Despite the paper claiming that all 12 children were "previously normal," five had documented pre-existing developmental concerns
  • Some children were reported to have experienced first behavioural symptoms within days of MMR, but the records documented these as starting some months after vaccination
  • In nine cases, unremarkable colonic histopathology results--noting no or minimal fluctuations in inflammatory cell populations--were changed after a medical school "research review" to "non-specific colitis"
  • The parents of eight children were reported as blaming MMR, but 11 families made this allegation at the hospital. The exclusion of three allegations--all giving times to onset of problems in months--helped to create the appearance of a 14 day temporal link
  • Patients were recruited through anti-MMR campaigners, and the study was commissioned and funded for planned litigation
Look what we have here!
First to crack was “regressive autism,” the bedrock of his allegations.38 39 “Bear in mind that we are dealing with regressive autism in these children, not of classical autism where the child is not right from the beginning,” he later explained, for example, to a United States congressional committee.40

But only one—child 2—clearly had regressive autism.41 Three of nine so described clearly did not. None of these three even had autism diagnoses, either at admission or on discharge from the Royal Free.

The paper did not reveal that two of this trio were brothers, living 60 miles south of the hospital. Both had histories of fits and bowel problems42 recorded before their MMR vaccinations.43 44 The elder, child 6, aged 4 years at admission, had Asperger’s syndrome,45 which is distinct from autism under DSM-IV, is not regressive,46 and was confirmed on discharge.47 His brother, child 7, was admitted at nearly 3 years of age without a diagnosis,48 and a post-discharge letter from senior paediatric registrar and Lancet coauthor David Casson49 summarised: “He is not thought to have features of autism.”50

The third in the trio, child 12, was enrolled on the advice of the brothers’ mother—reported in media to be a JABS activist, and who had herself “only relatively recently”51 blamed the vaccine. Child 12 was aged 6 at admission and had previously been assessed for possible Asperger’s syndrome at Guy’s Hospital, London, by a renowned developmental paediatrician.52 53 She diagnosed “an impairment in respect of language”—an opinion left undisturbed by Berelowitz.54 55

Mrs 12 was a GMC witness at its mammoth hearing, which between July 2007 and May 2010 ran for 217 days. She explained that the brothers’ mother had made her suspicious of MMR and had given her Barr’s and Wakefield’s names.56 Mrs 12 then approached them and filed a statement for legal aid before her son was referred.57

“It was like a jigsaw puzzle—it suddenly seemed to fit into place,” she told the panel, describing how she concluded, four years after the boy was vaccinated, that MMR was to blame for his problems. “I had this perfectly normal child who, as I could see, for no apparent reason started to not be normal.”

The 12 children were admitted between July 1996 and February 1997, and others had connections not revealed in the paper, almost as striking as the trio’s. The parents of child 9 and child 10 were contacts of Mrs 2, who ran a group that campaigned against MMR. 58 And child 4 and child 8 were admitted—without outpatient appointments59—for ileocolonoscopy and other invasive procedures, from one Tyneside general practice, 280 miles from the Royal Free, after advice from anti-MMR campaigners.60
All the numbers are references, I give you the first one for the lulz:
38 Andrew Wakefield. Evidence to the panel. (a) Day 49. “Q: What did you understand that phrase to mean, ‘pilot study’? A: This refers specifically and exclusively to the Legal Aid Board pilot study. That is, the investigation of five children with Crohn’s disease and five children with regressive autism and gastrointestinal symptoms.” (b) Day 52. “Q: The second aspect concerns the second box down, which is noted ‘Diagnosis’ and you see what you have written there: ‘Regressive autism + ? inflammatory bowel disease’. Again, what did you intend to convey by using that expression on this document? A: Based upon my understanding at the time, that was the likely diagnosis in this child.
What weasel words by Andrew Wakefield.

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Comments are moderated, because I am tired of Gerwyn-V99-The-Idiot and his moronic sockpuppets, and tired of the story of the two dogs, but I will try to publish everything else.

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