Vaccination Finding of Fact

by ceebs
Thu Jan 28th, 2010 at 10:22:48 AM EST

Doctor At Centre Of MMR Controversy 'Failed In His Duties', GMC Rules | UK News | Sky News

Dr Andrew Wakefield went against the interests of children in his care, the GMC's Fitness to Practice panel found.

He also acted dishonestly and was misleading and irresponsible in the way he described research later published in The Lancet medical journal, the panel of experts ruled at a hearing in London.

The doctor has argued that he had been acting in the children's best interests.

His research on 12 children with bowel disorders and autism was published in The Lancet in 1998.

Although it didn't make a proven link with the MMR vaccine, Dr Wakefield subsequently warned parents to have single jabs against measles, mumps and rubella. The claim has been widely discredited.

Dr Wakefield did not attend the hearing today, which has sat for 148 days over a two-and-a-half-year period.

Parents who believe their children were damaged by the MMR jab heckled the GMC panel as its members delivered their findings.

Tomorrows newspapers will be interesting, for example how the Papers who have whipped up a frenzy about the supposed link between the MMR vaccine and Autism report this.


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Its the "Its all a conspiracy" defence

Doctor at centre of MMR controversy 'failed in his duties as a responsible consultant', rules GMC | Mail Online

Speaking to the Mail on Sunday at the weekend, Dr Wakefield said he feared the GMC's decision today would be politically-motivated.

'If there's any justice, we should be cleared,' he said. 'However, there's the political backlash to consider. I fear the GMC will want to make an example of us.

'The issue was not about me, but about how to crush dissent. I scare the establishment because I care and I am diligent.

'I think they're terrified because they've not done adequate safety studies. I've been treated in the standard way in which people who raise these kinds of questions are treated.

'It's extremely challenging, but if I fail to stand up to the bullies, the price to be paid is enormous.'

Verdicts on the facts of the case were delivered today at the disciplinary hearing in central London which has so far cost at least £1 million. 



If you're not part of the solution, you're part of the precipitate.
by ceebs (ceebs (at) eurotrib (dot) com) on Thu Jan 28th, 2010 at 10:30:44 AM EST
whoa. I had to look up this one (the Sky report is a Murdoch Alert mash up). Recommending component separation of the combined vaccination didn't immediately strike me as malpractice, dubious but not criminal, since after all vaccination is still ordered. Publication of research  based on a 12 person sample is so ludicrous, it's difficult for me to imagine hysterical reaction to such obscure findings without assistance from the press and Wakefield Media LLC on the way up, as on the way down (Deer's mission is missing a foil.).

So to the particulars of the inquiry into Wakefield's medical practices...

[wiki] centred on claims, brought forth by journalist Brian Deer, that autistic and neurotypical children may have been subjected to unnecessary lumbar punctures [!!] and colon biopsies [!!],[5] including one colonoscopy that caused the child life-threatening perforations of the bowel [!!].[6]

WTF. Authorities will revoke Wakefield's license? And what's the likelihood of former "patients" civil suits?

Diversity is the key to economic and political evolution.

by Cat on Thu Jan 28th, 2010 at 11:04:35 AM EST
Publication of research  based on a 12 person sample is so ludicrous

It may be worse than that.  The GMC is also investigating where the twelve children came from.  It appears at least eight of them might have come to him specifically because he might be able to show a link between MMR and autism and was working on a legal case.  Wakefield had already received £50,000 of legal aid money from a firm of solicitors and subsequently received £435,643 (plus expenses).  

The lumbar punctures had to be cleared by an ethics committee as being in the best interests of the children.  Part of the matter before the GMC is whether or not they were genuinely clinically necessary, rather than conducted for research.

(paraphrased from Bad Science by Ben Goldacre)

by Sassafras on Thu Jan 28th, 2010 at 11:58:44 AM EST
[ Parent ]
Yes, indeed. I read some of Deer's backstory, noting commission of the research by solicitor Barr who doubtless selected and bound the subjects with what incentives remains to be confessed.

Sampling errors are blatant in narrative and empirical premises.

These invasive procedures moreover are given as data producing "clinical investigation" of non-specific colitis for the published report on autistic spectrum behavorial disorders-- I'm reading the pdf-- in addition to lab analyses.

Also the "research" states no hypothesis!

So Lancet "ethical" review of Wakefield's methodology after the fact and explicit approval of this qualification study publication rather than professional sanction is exponentially disturbing CYA.

Four children did not undergo psychiatric assessment in hospital; all had been assessed professionally elsewhere, so these assessments were used as the basis for their behavioural diagnosis...
   After bowel preparation, ileocolonoscopy was performed by SHM or MAT under sedation with midazolam and pethidine. Paired frozen and formalin-fixed mucosal biospsy samples were taken from the terminal ileum; ascending, transverse, descending, and sigmoid colons, and from the recturm. The procedure was recorded by video or still images, and were compared with images of the previous seven consecutive paediatric colonoscopies (four normal colonoscopies and three on children with ulcerative colitis), in which the physician reported normal appearances in the terminal ileum....
   Also under sedation, cerebral magnetic-resonance imaging (MRfuckingI), electroencephalography (EEG) including visual, brain stem auditory, and sensory evoked potentials (where compliance made these possible), and lumbar punctures were done.

Whether or not comparisons in the series are same case or among the same subjects or between sample and control isn't specified.

just WTF.

Diversity is the key to economic and political evolution.

by Cat on Thu Jan 28th, 2010 at 12:51:31 PM EST
[ Parent ]
Publication of research  based on a 12 person sample is so ludicrous, it's difficult for me to imagine hysterical reaction to such obscure findings without assistance from the press and Wakefield Media LLC on the way up

There is a politically active, and respectably organised and funded, anti-vaccination movement that pre-dates Wakefield's hack study. That "helped" too.

And what's the likelihood of former "patients" civil suits?

Unlikely. How many televangelists have been sued by the flock they fleece?

- Jake

"Terraforming your own planet to make it uninhabitable hardly counts as epic win." - ThatBritGuy

by JakeS (JangoSierra 'at' gmail 'dot' com) on Thu Jan 28th, 2010 at 04:53:09 PM EST
[ Parent ]
"the flock they fleece" is a most excellent basis for understanding. Wish I'd thought of that!

Diversity is the key to economic and political evolution.
by Cat on Fri Jan 29th, 2010 at 09:49:31 AM EST
[ Parent ]
Fortunately, I get all my vaccine news from Oprah and Jenny McCarthy, so I'll not be troubled by this.

Be nice to America. Or we'll bring democracy to your country.
by Drew J Jones (myfriends@thisispancakes.com) on Thu Jan 28th, 2010 at 11:40:42 AM EST
Ben Goodacre has written extensively on this at http://www.badscience.net/category/mmr/ and in his book of the same name.

He calls the chapter based on this "The Media's MMR Hoax" and, despite his damning dissection of the study, expresses disquiet that Alexander Wakefield looks like being hung out to dry by the media for a scandal largely created by the media.

It's one of Goodacre's general themes that science stories are written by non-specialists, even when a newspaper has specialists, because studies are far more newsworthy when they're misinterpreted.  A headline "fact" is taken out of context, and the reader is given no chance to assess how good the study actually was or whether its findings are significant.

This is quite personal to me, because my son was born in 1998, and I had to make the vaccination decision more-or-less at the height of the controversy. Single dose vaccines were withdrawn in this country, to prevent parents demanding those instead.  I considered going to Europe (as some families did) for the single vaccines, but it didn't really take much reflection to work out that six trips to France constituted a greater risk than the MMR (as well as being a wholly unnecessary additional risk for his older sister).

by Sassafras on Thu Jan 28th, 2010 at 11:43:22 AM EST
despite his damning dissection of the study, expresses disquiet that Alexander Wakefield looks like being hung out to dry by the media for a scandal largely created by the media.

I've known scientists who were misrepresented in the press, and I've known cases where the press ran with a story even after the scientists they quoted explicitly told them that they were being misrepresented.

Wakefield isn't one of those cases. He deserves everything he'll get.

- Jake

"Terraforming your own planet to make it uninhabitable hardly counts as epic win." - ThatBritGuy

by JakeS (JangoSierra 'at' gmail 'dot' com) on Thu Jan 28th, 2010 at 04:57:58 PM EST
[ Parent ]
He's not an obvious candidate for sympathy, I agree.

But who is responsible for the consequences of the MMR scare?  The dubious writer of a flawed and insignificant paper, or the media that ran the story and have pretty much denied all correction short of its writer's professional disgrace?  Scapegoating is an ugly process, whether or not we like the goat.

by Sassafras on Thu Jan 28th, 2010 at 05:41:15 PM EST
[ Parent ]
Wakefield is not blame-free when it comes to the media scare. This isn't a case of a dubious or marginal study being blown out of proportion by some university department's PR flacks. Wakefield himself took active part in the PR, and has played an active role in the UK anti-vax community. So Wakefield owns that scare just as much as the incompetent newsies who ran with it.

That doesn't detract from the press' blame for running with a half-assed, poorly researched story based on a single (unethically conducted) marginal paper whose lead author had a massive conflict of interest.

But blame, not unlike a computer virus, is not reduced in severity just because it is spread to more people.

- Jake

"Terraforming your own planet to make it uninhabitable hardly counts as epic win." - ThatBritGuy

by JakeS (JangoSierra 'at' gmail 'dot' com) on Thu Jan 28th, 2010 at 06:09:55 PM EST
[ Parent ]
Tomorrows newspapers will be interesting, for example how the Papers who have whipped up a frenzy about the supposed link between the MMR vaccine and Autism report this.

Either as a conspiracy or without any mention that they ever reported on it before. There will be criticism of the "the media" with the undertones that they mean those guys over there.

by Colman (colman at eurotrib.com) on Thu Jan 28th, 2010 at 11:53:53 AM EST
names should be named, But British Libel law would be an obstacle.

If you're not part of the solution, you're part of the precipitate.
by ceebs (ceebs (at) eurotrib (dot) com) on Thu Jan 28th, 2010 at 12:07:10 PM EST
[ Parent ]


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