Readers may have noted a novel development on my Articles page — a piece by me which was published today in the Guardian. This was a riposte to an article last week attacking me by Dr Ben Goldacre, which you can read here,
following the column I wrote on the MMR controversy in last week’s Daily Mail.

I have received a huge amount of support for both my articles — along with three like-minded letters printed in the Guardian yesterday. Following today’s piece, however, I have received a number of notable emails — notable, that is, for their extreme condescension and vitriol on the basis that I, as a mere non-scientist, not only never knew what I was talking about in the first place but have had the damned cheek to show up a professed scientist for his ignorance and bias. Not that they say that, of course — I’ve apparently merely exposed my own ignorance even more thoroughly.

So what do these scientists say that shows their superior grasp of evidence and commitment to scientific inquiry? Here’s a distinguished opinion from a biochemist:

You ARE a moron & an irresponsible hack. That is why you write for the Daily Jackboot. Do fuck off why doncha.

Slightly more temperately — if no less unscientifically — some correspondents claim that I have relied for most of my information on the Journal of Physicians and Surgeons, described by one as ‘a bunch of screaming fascists’ and which is not even listed by PubMed, the international directory of peer-reviewed medical publications. This, they say, underlines the fact that I cannot tell bad science from the real thing.

Not so fast. First, this totally ignores the various research papers* -- which have been published in a range of distinguished journals -- to which I referred in my article, along with the American Institute of Medicine, also all but totally ignored. In fact, I was entirely unaware of the existence of the Journal of Physicians and Surgeons until I wrote the Guardian article. Moreover, I have written extensively about MMR in the past, have read most of the literature and interviewed a large number of parents of affected children as well as government officials — which, I wager, is more than my Ph.D-laden correspondents, whose idea of ‘research’ appears to be a quick trawl through Google.

Because of such lazy web-surfing, they appear to be unaware that this Journal is a new publication dating from 2003, when it replaced the American Association of Physicians and Surgeons’ 'Medical Sentinel'. At this point, it changed its whole approach to something that appears to be much more rigorous. As a result, it is indeed being listed in PubMed later this year. PubMed requires a year's articles before it will consider listing a publication, and only meets once in a blue moon to consider them. So it's a slow process. The Journal says its papers are peer reviewed in the normal way by acknowledged experts. PubMed's imprimatur would appear to confirm this.

Above all, surely what matters is the quality of the science in these papers. No-one has shown there is anything wrong with the paper by Bradstreet et al showing the presence of measles virus in cerebro-spinal fluid. Ignoring the science while mounting what appears to be a smear campaign against the journal in which it is published seems to me to be a less than scientific approach -- compounded in several of these messages by virulent prejudice.

Next, I am accused of believing that epidemiology establishes proof when all it can do is estimate probability. Oh dear: another major point missed. It is not I who claim epidemiological proof but the government and others who claim that the epidemiology ‘proves’ MMR is safe. I’m the person saying there is no proof, remember?

Next, I’m told epidemiology can and does prove causal associations. Maybe so. I didn’t say it couldn’t or didn’t. What I said was that it could not disprove the clinical findings from a group of patients. Can’t these guys even read?

Next, I’m told (again) that I don’t understand that epidemiology is perfectly capable of disproving the Wakefield thesis. One correspondent wrote:

‘I can think of no scientist or doctor in my wide circle of colleagues in Oxford, Cambridge, London and Boston who would disagree with the main points of his [Goldacre’s] article.’

Oh dear oh dear. My observations are based on what I have been told by a wide variety of doctors and scientists, who tell me the limitations of epidemiology that I have highlighted are as accurate as they are elementary. Let me spell it out again for those who have difficulty understanding. In order even to begin to test Wakefield’s thesis with a degree of credibility, any such study would have to specifically test whether MMR had affected a small sub-set of vaccinated children. No epidemiological study has done this. They have therefore tested something which Wakefield never alleged. One does not have to be a rocket scientist — or indeed any kind of scientist — to spot this most elementary of flaws.

All those who so kindly suggested that I did not know my epidemiology from my elbow might also care to reflect on this, from the American Institute of Medicine's report on the MMR controversy:

The evidence favours rejection of a causal relationship at the population level between MMR vaccine and ASDs [Autism Spectrum Disorder]…However, the committee notes that its conclusion does not exclude the possibility that MMR vaccine could contribute to ASD in a small number of children because the epidemiological evidence lacks the precision to assess rare occurrences of a response to MMR vaccine leading to ASD and the proposed biological models linking MMR vaccine to ASD, although far from established, are nevertheless not disproved.

The IoM recommended the issue should receive 'continued attention' -- which it never has, except from those who wish to bury it.

What price the future of science, when so many of today’s alleged practitioners appear not to understand the difference between fact and fulmination?

*Some papers endorsing or replicating the Wakefield research:

1) Evaluation of an association between gastrointestinal symptoms and cytokine production against common dietary proteins in children with autism spectrum disorders;
Harumi Jyonouchi MD, Lee Geng PhD, Agnes Ruby BS, Chitra Reddy MD and Barbie Zimmerman-Bier, MD

Journal of Pediatrics, May 2005, p 610

2) Dysregulated Innate Immune Responses in Young Children with Autism Spectrum Disorders: Their Relationship to Gastrointestinal Symptoms
and Dietary Intervention;
Harumi Jyonouchi Lee Geng Agnes Ruby Barbie Zimmerman-Bier Department of Pediatrics, New Jersey Medical School, UMDNJ, Newark, N.J. , USA

Neuropsychobiology 2005;51:77–85

3) Some aspects about the clinical and pathogenetic characteristics of the presumed persistent measles infections: SSPE and MINE;
Paul Richard Dyken, Institute for Research in Childhood Neurodegenerative Diseases, Mobile, Alabama, U.S.A.

Journal of Pediatric Neurology 2004; 2(3): 121-124

4) Spontaneous Mucosal Lymphocyte Cytokine Profiles in Children
with Autism and Gastrointestinal Symptoms: Mucosal Immune
Activation and Reduced Counter Regulatory Interleukin-10
Paul Ashwood, Andrew Anthony, Franco Torrente and Andrew Wakefield

Journal of Clinical Immunology, Vol. 24, No. 6, November 2004 ( C_ 2004)

5) Panenteric IBD-Like Disease in a Patient with Regressive Autism Shown for the First Time by the Wireless Capsule Enteroscopy: Another Piece in the Jigsaw of this Gut-Brain Syndrome?
Federico Balzola , Valeria Barbon , Alessandro Repici , Mario Rizzetto , Daniela Clauser , Marina Gandione , Anna Sapino.

American Journal of Gastroenterology, April 2005

6) Gastrointestinal abnormalities in children with
autistic disorder
Karoly Horvath, MD, PhD, John C. Papadimitriou, MD, PhD, Anna Rabsztyn, Cinthia Drachenberg, MD.

Journal of Pediatrics, Vol 125, no 5

7) Autistic disorder and gastrointestinal disease
Karoly Horvath, MD, PhD, and Jay A. Perman, MD

Pediatrics 2002, 14:583–587

Posted by melanie at November 8, 2005