For people who know about autism science, it is really clear what the incorrect info/misrepresentation is, in both the 'Never Mind the Facts' article and in the 'Hoax' extract. And it is clear why it is significant.
Again whether you agree with Wakefield et al or not, I think most of us can agree that there are logical stages and steps to the scientific method. I imagine that good old Ben knows this too because he knows so much about what makes for good or bad science that he writes a column, a blog and books on the matter.
I imagine most of us can agree that human biology is complex and that there are interactions between the different systems of the human body. This makes studying the human body quite complex.
I think we can agree that the scientific method doesn't generally allow one to say stuff like 'smoking causes cancer' without going through a logical and ordered scientific process.
You work through stages. The first stage might be to observe that you have a group who present with lung cancer and to describe the pathological manifestations of the condition. You might then observe after taking a number of patient histories that there are disproportionate numbers of people who smoke in this group. So you generate a hypothesis asking if there is a link between lung cancer and smoking. Then you design methods for testing that hypothesis. Part of all this process will be to use outside knowledge such as information on how the respiratory system works or knowledge about the composition of cigarettes and the properties of their ingredients. You will add in information about how those ingredients can affect body systems.
It may take a process of a number of years to get to a place where you can say with a reasonable degree of certainty that the balance of evidence is that smoking leads to cancer in susceptible individuals. You may have found out a fair bit along the way of what makes these individuals susceptible to this consequence of smoking.
As often happens in medicine, discoveries can be made when a condition is examined from a different angle. For example, for a long time eczema was treated as a skin condition only - now we know that it can often be a problem with the immune system which manifests as a skin condition. If we only examined the skin but never took blood tests of IgE levels (i.e. we examine the immune system), we would be missing out on a lot of information about an individual's condition. If we fail to observe that an individual's condition flares up after eating certain foods, because we don't understand the connections between the digestive system, the immune system and the skin organ, we are missing out on information which is useful for treating the patient.
Which brings me round to why it is important for commentators like Goldacre to get their facts right.
Goldacre doesn't just get a date wrong. That wouldn't be a big deal. If he talked about the 2002 Lancet Paper but then went on to describe the correct content of the paper, it wouldn't affect people's understanding terribly badly.
But that isn't what he does.
What he does is talk about the Lancet paper as though it was a paper which was written much later in the timeline of the scientific process. In doing so the readers miss some very important information. Some key information. Information, without which, it is unlikely one can have a clear understanding of, well, anything much about the affair really.
Now this is a pretty bad error for a chap like Goldacre to make. It isn't just a typo of getting a date wrong.
I said earlier that autism is complex. I also said that the Wakefield affair is complex. The 1998 Lancet paper, however, is not very complex. It is quite short, and it is easy to summarise the main observations it contains.
The 1998 Lancet paper was authored by a team from a gastroenterological department. The reason for this is because it dealt with a gastroenterological condition - a condition that the team had not seen before.
That was why they published their case series report. Because they were describing gut problems that had not previously been observed or written about. (Remember a key member of this team is Professor Walker Smith, the most experienced and eminent paediatric gastroenterologist in the UK. He agreed that this discovery was a discovery. And what do scientists do when they make a discovery? They write a paper on it.)
What was really interesting about this gut condition was that it occurred in children who had another health issue. They had behaviour issues and were somewhere on the autistic spectrum.
What was even more interesting was that the children's behavioural problems improved when their inflamed guts were treated. And that was great because the children not only suffered less suffering due to their gut pain, they also suffered less behaviour stress. Win win right?
Of course it seemed logical that being in pain would cause children to 'act out', especially if the children were non-verbal. You take away the pain and stuff like posturing or hand banging stops because those behaviours were expressions of pain.
However, there was a bonus with these children because other things improved too in some of them. Children who had regressive autism regained some of their lost skills. Nonverbal children began to speak for example.
And that was really exciting. Because with fairly simple gastroenterological treatments and diet changes, doctors were able to help severely distressed children who nobody had been able to do much for before.
These factors did not occur in all children with ASD, but they did with a significant group.
The above are the most significant things about the gastroenterological discovery written up in the 1998 Lancet paper.
And Goldacre, with his errors, puts all these things totally out of the picture.
The reason these children were examined by the Royal Free team, was because they showed signs of gut distress - they had severe constipation or diarrhoea, there was undigested food in their stools, some of them suffered faecal incontinence.
And these were all children who had suffered neither gut problems nor behavioural ones in the first 1 to 2 years of their lives.
And when taking their medical histories, their parents said that the symptoms had started following measles/MMR vaccination. (And this was true for lots of children the Royal Free saw, not just the Lancet 12.)
And under examination, aspects of their gut inflammation were concordant with symptoms of inflammation of a viral origin.
And some of the manifestations of the children's regression were similar to brain issues that measles can cause. Issues that have been observed in what gets called 'atypical measles exposure' - one example of this type of exposure is when a person contracts measles in close temporal association with certain other viruses such as mumps or chicken pox.
And this is when the Royal Free team realised that they were in deep shit.
Of course there is loads of other information that is also relevant - Wakefield had been researching viral insults and their affect on the digestive system for quite some time before he encountered the Lancet children.
He and his team knew that the next logical step was to examine the children for persistent measles infection.
Goldacre's errors, reduce all of the above to an incomprehensible 'doctor randomly tries to make out there is a link between MMR and autism on the basis of nothing more than a hypothesis conjured up out of nowhere and getting carried away by the coincidence that autism manifests around the same time children get their jabs'.
Which is a very very silly story. But people go for it.