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The Lancet Recants Study Linking Autism To Vaccine
JamJam writes "The Lancet, a major British medical journal, has retracted a flawed study linking the measles, mumps, and rubella vaccine to autism and bowel disease. British surgeon and medical researcher Andrew Wakefield and his colleagues originally released their study in 1998. Since then 10 of Wakefield's 13 co-authors have renounced the study's conclusions and The Lancet has said it should never have published the research. Wakefield now faces being stripped of his right to practice medicine in Britain. The vaccine-autism debate should now end."
Here's the actual retraction, rather than reporting on reporting on the retraction:
The Lancet, Early Online Publication, 2 February 2010
doi:10.1016/S0140-6736(10)60175-7
Retraction—Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children
The Editors of The Lancet
Following the judgment of the UK General Medical Council's Fitness to Practise Panel on Jan 28, 2010, it has become clear that several elements of the 1998 paper by Wakefield et al(1) are incorrect, contrary to the findings of an earlier investigation.(2) In particular, the claims in the original paper that children were "consecutively referred" and that investigations were "approved" by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record.
References
1 Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 1998; 351: 637-641
2 Hodgson H. A statement by The Royal Free and University College Medical School and The Royal Free Hampstead NHS Trust. Lancet 2004; 363: 824.
Put my fist through my alarm clock with its ding-dong death inside my ear. - The Blackjacks.
So why exactly should I not believe the original study? From where I stand (which is little to zero knowledge on the subject) I could conclude that each of the co authors one by one were persuaded by the various pharmaceutical companies which standed to be harmed by this research.
From Quackwatch.org:
The only "evidence" linking MMR vaccine and autism was published in the British journal Lancet in 1998. An editorial published in the same issue, however, discussed concerns about the validity of the study. Based on data from 12 patients, Dr. Andrew Wakefield (a British gastroenterologist) and colleagues speculated that MMR vaccine may have been the possible cause of bowel problems which led to a decreased absorption of essential vitamins and nutrients which resulted in developmental disorders like autism. No scientific analyses were reported, however, to substantiate the theory. Whether this series of 12 cases represent an unusual or unique clinical syndrome is difficult to judge without knowing the size of the patient population and time period over which the cases were identified.
If there happened to be selective referral of patients with autism to the researchers' practice, for example, the reported case series may simply reflect such referral bias. Moreover, the theory that autism may be caused by poor absorption of nutrients due to bowel inflammation is senseless and is not supported by the clinical data. In at least 4 of the 12 cases, behavioral problems appeared before the onset of symptoms of inflammatory bowel disease. Furthermore, since publication of their original report in February of 1998, Wakefield and colleagues have published another study in which highly specific laboratory assays in patients with inflammatory bowel disease, the posited mechanism for autism after MMR vaccination, were negative for measles virus.
second entry on Google:
http://online.wsj.com/article/SB10001424052748704022804575041212437364420.html
Ten of the 13 authors of the original paper, all of whom were researchers at the Royal Free Hospital and School of Medicine in London, partially retracted the paper in 2004. However, the first author, Andrew Wakefield, didn't. Dr. Wakefield, who is now at the Thoughtful House Center for Children in Austin, Texas, didn't immediately return phone calls seeking comment.
"Many consumer groups have spent 10 years waging a campaign against vaccines even in the face of scientific evidence," said Dr. Horton of the Lancet. "We didn't have the evidence back in 2004 to fully retract the paper but we did have enough concern to persuade the authors to partly retract the paper."
The Lancet decided to issue a complete retraction after an independent regulator for doctors in the U.K. concluded last week that the study was flawed. The General Medical Council's report on three of the researchers, including Dr. Wakefield, found evidence that some of their actions were conducted for experimental purposes, not clinical care, and without ethics approval. The report also found that Dr. Wakefield drew blood for research purposes from children at his son's birthday party, paying each child £5 (about $8).
The Lancet's Dr. Horton said the journal was particularly concerned about the ethical treatment of the children in the study, and that the children had been "cherry-picked" by the study's authors rather than just showing up in the hospital, as described in the paper.
The authors "did suggest these children arrived one after another and this syndrome was apparent, which does lead you to think this is something serious," said Dr. Horton.
Why should you not believe Wakefield?
(1) Wakefield performed at least some parts of his study in an unethical manner.
(2) Subsequent to the publication of this study, other researchers have tried to duplicate Wakefield's results but nobody has succeeded in doing so.
(3) Wakefield is not a disinterested party; he has received a great deal of money from those who stand to profit from his conclusions.
(4) Various circumstances [including (2) and (3) above] have caused others in the medical community to suspect Wakefield of fraud related to this "study".
The guys over at Science-Based Medicine have you covered: http://www.sciencebasedmedicine.org/?p=3660
If you look back through their post archives, you can find dozens more touching on the subject of Wakefield's paper in particular and vaccines in general, among other things.
I used to get high on life, but I developed a tolerance. Now I need something stronger.
Click on Dr. Wilson's link to see his copy of a graph showing the slight drop in MMR vaccinations resulting in a sharp increase in measles cases. Fortunately, a mere thousand or so more per year will only mean a couple of deaths, blindings, sterilizations, and so forth. Words fail me.
The unethical conduct is just the last nail in the coffin.
1. The original supposition, based on 12 patients, was that MMR vaccine may have been the possible cause of bowel problems which led to a decreased absorption of essential vitamins and nutrients which resulted in developmental disorders like autism. No analysis was provided to substantiate this, it was pure unfounded supposition.
2. Subsequent laboratory assays on the patients in question found no evidence of measles virus DNA, indicating that the vaccine was not responsible for the cases of inflammatory bowel disease.
3. Clinical evidence doesn't support a link between IBD and autism.
4. Twelve subsequent studies have failed to find any evidence of a link between MMR and autism.
Calling the possibility of a link "laughably remote" is an understatement.
upon the advice of my lawyer, i have no sig at this time
Scientists are, by nature, skeptics. They don't believe anything you tell them; they have to see the data themselves and replicate the results. In science, if you make a claim, but can't substantiate it, then your claim is unproven.
The Lancet is retracting the original paper not because the claims were not substantiated by further studies; normally the paper would remain in publication. Subsequent investigations also found that the study was highly flawed and that Wakefield misrepresented or changed data to support his claim.
In the original study, Wakefield reported 8 of 12 children in a hospital clinic experienced symptoms of autism as well as inflammatory bowel disease within days of a vaccination. Later investigation revealed that the autism symptoms described by Wakefield were different from those described to the hospital, and that in only one case did the autism symptoms occur a few days after the vaccination. The majority were reported before the vaccination occurred. Hospital physicians at the time did not find any signs of inflammatory bowel disease but the study reported that they did.
Dr. Wakefield's integrity was questioned when it was revealed that he had been paid by parents of autism children to determine if the MMR vaccine was the culprit. This conflict of interest was not reported to the Lancet before the paper was published.
Well, there's spam egg sausage and spam, that's not got much spam in it.
The problem was not the sample size, pilot studies like this are common. The problem was the dubious methodology that Wakefield used in generating the paper, namely not disclosing his a patent application, payment by an attorney specifically to support the claim that the MMR is linked to autism, and his selection of children whose parents were involved in such law suits by the same attorny when he said he randomly selected them. This was brought up first by Brian Deer http://www.timesonline.co.uk/tol/life_and_style/health/article5683671.ece and led to a two-and-a-half year ethics investigation by the General Medical Council, which found the he acted “dishonestly and irresponsibly" http://news.bbc.co.uk/2/hi/health/8483865.stm
It certainly raises a red flag for me when you consider that a single vaccine can give a child an exposure 5-10x the OSHA limit for mercury poisoning.
It doesn't. The OSHA limit is for chronic exposure to methylmercury. Thimerosal exposes you (via breakdown) to ethylmercury, and only once. It's the wrong substance and is a non-chronic exposure. There is not an established toxicity for ethylmercury, as far as I recall -- it is generally thought that the toxicity is lower than methylmercury, and so the limits for methylmercury are used. (But again, the limit you are referring to is the chronic-exposure limit.)