to be a little in love with Ben Goldacre?

[entropyglitter]

Just read 'bad science' (finally) and I think I am in love.....

my favourite bit was Gillian McKeith thinking that oxygen (generated by chlorophyll) in your gut is not only plausible, but at all a good idea....

presumably this is at the same time as main lining anti-oxidants (which had been shown to increase your risk of disease rather than decrease it).

My predictiive post of Mon 09-Jan-12 21:16:25 refers :)

Ben Goldacre
Fiona Goodlee (editor of BMJ)
Brian Deer (journalist who exposed Wakefield scandal)
Various members of the GMC
Richard Horton (editor of The Lancet)

What do these people all have in common:

1. They were involved/supported wakefield's indictment
2. they have all been accused of corruption by Wakefield supporters

Ben Goldacre is in very good company.

Wow! Things have moved........ on.

Just to say that one of DH's colleagues tried to book BG to speak for them at an event recently but apparently he is pretty expensive. Apropos of nothing. Shall I try and find out how much and then those of us who like him can arrange a secret MN event, all chip in and get to worship in person?

And if having a father in the same field as you was a COI then half the medics I know would never get anything published (or the teachers, for that matter)

entropy nice thread, but I'm afraid that's it for me now. Can't be doing with vaccine debates.

gah - Im still stuck on it being a conflict of interest to have worked in the same building as someone who wrote a research paper about vaccine safety....

To say that knowing people that do research in an area precludes you from being a suitable person to try and disseminate information on said research to the public seems...well...backwards?

I wonder if the sticking point is that this isnt about feelings and opinions its about fact. Scientists that work with each other generally dont hesitate to denounce their colleagues work if they are actually wrong. There isn't a lot of 'oh well turn a blind eye coz he is a mate of mine' possibly because when the rest of the academic world takes a look at the research, you wouldnt want to be standing next to the person you suspect has been falsifying data....

Also not really getting the whole ASD not a genetic condition business. Current scientific opinion would appear to be (at a glance) that in some cases the genetic cause is a single mutation, in others it is a mixture of mutations, in yet others it is caused by exposure in the first 8 weeks of pregnancy to teratogenic compounds. A lot of cases are not easily attributable and currently it is thought that the genetic risk factors for ASD are complicated.

Given all that, why is it inappropriate to attribute at least some ASD to genetics?

The UK government knew that the Urabe vaccine was associated with cases of meningitis, febrile convulsions and encephalitis in Canadian children. They knew this before the vaccine was introduced to the UK. They introduced the vaccine anyway. And sure enough it caused all of the above in British children too.

The vaccine was withdrawn in Canada in 1987 and introduced to the UK a year later in 1988. It was then withdrawn from the world market by the manufacturer Smith Kline Beecham in 1992 with, I believe, only one weeks notice given to the DoH. It seems that had the manufacturer not withdrawn the vaccine that the DoH intended to carry on using it - which is potentially very embarrassing for the government considering the high reports of adverse reactions made to the Committee on Safety of Medicines.

In this context, the above government sponsored paper, co authored by Goldacre senior, with its suggestion/implication that the vaccine reactions were mainly asymptomatic cases of viral meningitis with non-related febrile convulsions and no mention of encephalitis, is most odd.

The government knew years before this paper was published, that the Urabe vaccine was associated with febrile convulsions, encephalitis and brain damage. They knew that the manufacturer had withdrawn the vaccine due to high levels of these serious adverse events. That they spent money on this wishy washy paper which downplays knowledge of serious events, knowledge that was in their possession years before, just doesn't look good.

For the record I dont think that anyone thinks that BG is an impartial bystander in these debates. He is very obviously, solidly and rabidly on the side of evidence based medicine. I certainly don't think that it is a hidden agenda :)

beach you are back....can you explain the ASD nothing to do with genetics thing?

Entorpy why are you downplaying Goldacre's place in the IoP with regards to his independence as a journalist?

He should at the very least declare his fellowship in an institution which has position on ASD issues and which has members who have written some of the most important papers in defence of MMR safety (papers which Goldacre cites in his journalism).

It just all feels a bit too cozy for my liking.

Perhaps all this has zero influence on Ben's opinions on MMR. I just think the public deserve to know these things about him, in the interests of transparency - something Goldacre is always recommending so very highly to others.

I do not claim that ASD has nothing to with genetics.

I'm saying that prominent members of the IoP such as Rutter and Fombonne denied that ASD was on the increase and made strong claims that autism was mainly a genetic disorder despite evidence to the contrary.

Current knowledge, particularly in the US, shows three things;

• it is too simplistic to talk about autism, the term 'autisms' is preferred to reflect the spectrum of both manifestations of autism, and, causes of autism.
• ASD rates have increased very significantly over a short time, therefore there must be factors at play other than genetics.
• It is considered, by many in the US, more correct to talk of genetic predispositions interfaced with environmental trigger factors.

I think that, given the gleeful way BG writes about other people, it is snigger-worthy that he keeps a bit quiet about his dad. I wouldn't know if it's a COI because I know nothing about it, but it is pretty funny, I'm afraid.

Also, whoever observed (with a touch of pomposity I felt) that Guardian journalists don't habitually mention who their fathers are has clearly never read the Guardian.

I enjoyed his book and think there is a lot of good in it, but I can quite believe he's a bit of a prick in RL. A qualified scientist, clever bloke kind of prick, but if you like smug debunking of bad science there are better writers out there.

It may suggest, beachcomber, it doesn't show. If you want to debate at a decent level, you'll need more scientific terminology.

For example your point here: "- ASD rates have increased very significantly over a short time, therefore there must be factors at play other than genetics."

Dearie me, no no no! We can't bandy round such assertions. One could just as easily say that ASD diagnoses have increased significantly, which is not at all the same thing. And there is no possibility of a MUST after your therefore.

He is very obviously, solidly and rabidly on the side of evidence based medicine.

What such as papers by Fombonne, cited by Goldacre, which claim no increase in ASD rates?

Papers which the Cochrane report dismiss for their flawed methodology?

The IoP is a research centre. Does the centre itself have a position, or does it simply employ researchers who have published on the subject and who may hold an opinion?

If the latter, I can see why he wouldn't make a big deal of something both irrelevant and open to significant misinterpretation.

The Urabe strain is associated with adverse events of meningitis. However, mumps also causes meningitis. The Urabe strain is a more effective vaccine against mumps than the vaccine strains that aren't associated with meningitis.
It is possible that using the Urabe strain, due to it being more effective at preventing wild mumps might end up with fewer incidents of meningitis overall due to a lower incidence of wild mumps causing meningitis.

So it is not that straightforward to say 'it causes meningitis, it must be banned'. There needs to be a careful analysis of the risk to benefit ratio.

"with its suggestion/implication that the vaccine reactions were mainly asymptomatic cases of viral meningitis"

They said that it couldn't be ruled out. It wasn't their suggestion, I think it was suggested in a different paper, so they addressed it. If incidents of meningitis increase as they look for meningitis, it suggests that at least some meningitis could be asymptomatic and they only found it because they were looking. All they said was that they couldn't rule that out - I think it is quite tricky to design studies to prove a causal link between vaccines and adverse events.

Actually the argument that the increase is just down to an increase in diagnoses/changes to diagnostic criteria, has been shown to not be able to account for current rates.

oooh, examples please LRD? Loved Bad Science and would enjoy more of the same.

I looked at the IoP website and I couldn't see anything about their 'stance' on ASD on their about page

I'm glad you say that tyaca.

(Btw, there isn't anything hyper-feminist about the book, it just happens to be a standing recommendation by a few posters including me, who like to bore people's socks off about it.)

I like Trick or Treatment - Alternative Medicine on Trial by Simon Singh and Edzard Ernst.

Prof Edzard Ernst used to be a homeopath which goes to show that some people do change their minds in the face of the evidence.

Ooh, thanks noblegiraffe. Just ordered from Amazon. :)

(And there is nothing more impressive than people whose positions alter when exposed to new evidence. That takes grace, as well as brains.)

Great posts LRD

Thanks for the book recommendation - it sounds great

beach
I understood that the changes in diagnostic criteria and also better surveillance accounts for much of the increase in ASD. Also increasing mean parental age at birth accounts for some as well. What % of the increase do you think is still unexplained and based on what scientific evidence?

I've ordered the Cordelia Fine book, looks really interesting.

The Institute of Psychiatry on ASD.

Profile of their lead researcher

Their focus is clearly not on the increase in ASD rates, potential environmental triggers or associations with gastrointestinal disease. Which is fair enough - they are a psychiatric research institute, not one of environmental medicine or gastroenterology. They examine ASD within their psychology department.