So, can we lock him up now?

[lederhosen]

I already knew Andrew Wakefield's paper on the MMR vaccine - the one that caused vaccination rates to plummet in the UK - was based on a sample of just twelve children, and that Wakefield failed to disclose a major conflict of interest. Via james_nicoll, it turns out that even those twelve cases aren't trustworthy:

In most of the 12 cases, the children’s ailments as described in The Lancet were different from their hospital and GP records. Although the research paper claimed that problems came on within days of the jab, in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated. Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal.

Despite involving just a dozen children, the 1998 paper’s impact was extraordinary. After its publication, rates of inoculation fell from 92% to below 80%. Populations acquire “herd immunity” from measles when more than 95% of people have been vaccinated.

Last week official figures showed that 1,348 confirmed cases of measles in England and Wales were reported last year, compared with 56 in 1998. Two children have died of the disease.

At the very least, I hope Wakefield is never allowed to practice medicine again. (This sort of thing, BTW, is why House makes me uncomfortable - I've no doubt that Wakefield has genuinely convinced himself that there's a link, and therefore the ends justifies the means; unfortunately, in the real world, doctors with hunches are often disastrously wrong.)

Meanwhile, the fire stories from Victoria are just awful. Now up to 84 confirmed dead, probably more. Called my stepmother, and her family are currently okay; will check on my sister-in-law tomorrow.

Comments

[nefaria.livejournal.com]

Have subsequent tests thoroughly refuted his claim? His study sounds thoroughly invalid, but that doesn't necessarily mean his claim is false, just that he has no valid proof of it.

[thette.livejournal.com]

Yes. Please read up on this before making those kind of claims. You're part of the problem.

[nefaria.livejournal.com]

It was a logical argument on my part: the fact that an invalid proof of X exists does not imply that X is false.

And no, I am not a part of this problem, I have nothing to do with it.

[lederhosen.livejournal.com]

FWIW, I thought it was a reasonable question to ask. But I'm the sort of person who will happily argue against a proof of something I strongly believe in, if I don't like the proof.

For actual answers to the question, Wikipedia cites multiple large epidemiological studies that found no link between MMR and autism. Institute of Medicine report is here; CDC one seems to be broken at present.

[nefaria.livejournal.com]

I had mixed feelings when I first heard it, I thought it had something to do with mercury. I know the USA had all these rules about keeping mercury away from kids, even small doses can cause severe damage, BUT it's perfectly safe in dental fillings! Honest...

So, I was skeptical at first, but it does seem to be bad research on Wakefield's part. According to Wikipedia, the MMR vaccine can have some bad side effects (very rare) but the benefits seem to far outweight the downsides.

[lederhosen.livejournal.com]

I had mixed feelings when I first heard it, I thought it had something to do with mercury.

Okay, this is where it gets confusing. There's a mercury-based preservative called thimerosal that's used in some vaccines (although now being phased out).

Part of the vaccination-autism scare involved vaccines containing thimerosal (and I can certainly understand people being concerned about mercury compounds). Another part of the scare involved the MMR vaccine - I think the MMR scare got a bigger share of the coverage in the UK than it did in the USA, possibly because Wakefield is UK-based. Sometimes the two get blurred together, and people have claimed that thimerosal in MMR causes autism... even in areas where thimerosal isn't actually used in the MMR vaccine.

(And yes, MMR vaccination has side-effects up to and including death, but nowhere near those from the diseases it protects against.)

[cheshire-bitten.livejournal.com]

Thankyou. That was a great comment.

[cerebresque.livejournal.com]

Technically, I only have no valid proof of my claim that dogs prevent earthquakes - no-one's refuted it - but somehow they're not sending me a check to ship 350,000 of them to California.

[scascot.livejournal.com]

Meanwhile, despite providing all this evidence to the contrary, the wife of sarapooh's cousin still refuses to have her two children vaccinated for anything, believing that this quack (Wakefield) is right.

Of course, every time we see them, one (or both) of the children are sick, and their mother can't understand why.

[lederhosen.livejournal.com]

One of the things that frustrates me is that some people will actually take stories like this as support for Wakefield's case. If he's being investigated for ethics violations, it means the Evil Medical Establishment must be trying to suppress him, which means he's onto something... and no matter how thoroughly his 'evidence' is demolished, they'll keep on chanting 'no smoke without fire' :-(

[scascot.livejournal.com]

I just had an incidence of that not 2 hours ago - I pointed this article to someone, and they (being a naturopath) launched into the tirade you mentioned.

After they were done, I looked at them, and asked, "You're not serious, are you? I mean, <theory hole #1> <theory hole #2> <manipulated data>..."

Which elicited another tirade.

*sigh*

[cerebresque.livejournal.com]

(This sort of thing, BTW, is why House makes me uncomfortable - I've no doubt that Wakefield has genuinely convinced himself that there's a link, and therefore the ends justifies the means; unfortunately, in the real world, doctors with hunches are often disastrously wrong.)

Per season four episode six, it would appear that House agrees with you where ends and means are concerned.

[lederhosen.livejournal.com]

At least where the doctor in question is somebody other than himself... I'm pretty sure I've seen several incidents where House let his own hunches override a lot of the usual safeguards against malpractice, but I can't cite them just now.

[cerebresque.livejournal.com]

...every episode, I should think. But while that's true, I would note that every specific time I can recall House deciding that the ends justified the means, the ends were still "the good of his particular patient", rather than the 4x6 example quoted above or Wakefield, who were using their patients as instrumentalities towards other ends. So that seems to be the line that he draws.

(Of course, being somewhat of a cynic with regard to where the boundary between safeguards against malpractice that protect the patient from harm and the safeguards against malpractice that protect others from legal liability tends to be, vide. for example the unavailability of experimental treatments even to people whose choice is "...or death", my sympathies lie several steps House-ward of yours, I suspect.

If slightly bounded by the non-fictional world geniuses with his consistent success rate...)

[lederhosen.livejournal.com]

You might be surprised - I'm very much in favour of letting competent adults make informed risk decisions, and I'd much rather concentrate on improving the quality of information available to them than on restricting their choices.

Problem is, even if RL had a few House-level medical geniuses around, it's not practical to say "ignore the rules if you're a genius". People just aren't that good at self-evaluation. So we end up with a tradeoff between letting a handful of geniuses save a handful of people by breaking the rules, or letting a truckload of overinflated 'geniuses' kill people through whatever brand of quackery they firmly believe in.

(more later, bus time.)

[lederhosen.livejournal.com]

The other thing that bothers me about House - I think I mentioned this on Turnberry's journal - is that while he always works for the good of the patient, I'm not convinced that really constitutes 'ends'.

My interpretation (usual caveats apply) is that House is a control freak who likes having and exercising the power of life and death, and saving people's lives is one of two equally effective ways of basking in that power - maybe a bit more enjoyable because it's a harder challenge, but actual benevolence towards his patients is relatively low on the list compared to the fun of problem-solving.

It's still good news for his patients, but he's a little too close to a Harold Shipman type for my comfort.

[cerebresque.livejournal.com]

Given the evidence you have, you might very well be right.

Of course, as I think I might have mentioned before, given the choice and the choice of making the choice, I'll take that guy in a heartbeat myself. (I'll take the non-benevolent problem-solver over someone who'll empathise me to death, any day, and I have a profoundly cynical view of the practical value of active benevolence.)

[lederhosen.livejournal.com]

I might take the same choice, but I don't have to be comfortable about it ;-)

(I think this is an example of 'hard cases make bad law'; there are fictional settings where doctors like House can do a lot of good, but IRL letting doctors run amuk tends to end up in bad places.)

[manna]

I hope that the GMC smacks Andrew Wakefield down *hard*. Even by the shoddy standards of a lot of research done by medics, the measles paper was bad. I read it when it came out -- I was working in a virology lab at the time -- and even without any of it being fabricated it was manifestly a load of utter tripe.

The Sunday Times needn't look so smug about things, mind you. I still haven't forgiven them for their appalling championing of HIV denialism in the early 1990s. Yes, I can hold a grudge.


(Is Ceredwyn okay with the fires, do you know? I checked her LJ, but I can never figure out what LJ timestamps on posts actually mean.)

[lederhosen.livejournal.com]

They had some fires up that way, but nothing too bad last time I heard.