Dr. Wakefiled and the MMR study

[Uwila]

"If found guilty, Mr Wakefield could be struck off the medical register."

\link{http://news.bbc.co.uk/1/hi/health/5070670.stm\MMR Doc to face charges}

Discuss, please.....

I don't think he is unique in non disclosure of potential conflict of interest. If the government do want take up of MMR to continue to improve then this probably won't help as any reignition of the MMR and autism debate leads to a downturn in MMR vaccination. It will perhaps be another chance to bring into the discussion some more recent studies though.

There isn't actually a complainant in the case..the general medical council are bringing it "in the public interest"

Oh please. Persecuting Wakefield will not help their cause. I'd bet my last fiver they aren't investigating all the other authors who have failed to disclose their interests - IIRC back in '98 none of the major medical journals required people to state this. And they aren't going after the big drug companies who have suppressed key studies such as those which suggested Seroxat made people commit suicide. That's a case where manipulating publication killed 100s (if not more) of people. But let's go after Wakefield and not bother the big corporates.

And I'm not convinced that being an expert witness is a conflict of interest. Yes, you should disclose it (although not sure that was policy at the time) but expert witness are expected and instructed to give an unbiased assessment of the facts. How come Meadows gets off (by the body which regulates the GMC) while Wakefield is accused? Could it be because Wakefield is politically inconvenient while Meadows was part of the establishment? And the organisation that is questioned by Wakefield is the government, while the people affected by Meadows are only mothers, and mainly working-class women at that?

I'm not sure Wakefield was right. But I do know the forces ranged against him will stop at nothing to discredit him. Have seen the same tactics used against those who raised very valid questions against Seroxat. And against my own publication when we demonstrated serious failings at NHS Direct, that could equally have cost lives.

And the authorities sure aren't putting the same energy into supporting families with autism. Or studying the subset of children Wakefield looked at, who have autism and gut disease.

GMC should be bloody honest and say they are bringing it at the behest of the government.

I saw red mist when I spotted this over someone's shoulder on the train. They've hounded him out of the UK and out of the NHS...yes, I agree that he was probably wrong - but as edam says, there are many worse people out there.
I always felt Rodney Ledward was a case in point - and I would still never trust a child of mine to Marietta Higgs, who I daresay is working as paediatrician somewhere in the UK. Probably not in Middlesbrough though.
Thanks to discussions on here (thanks to Jimjams and her Sunderland links) I felt confident enough to make the decision that I could let dd have the MMR (after choosing single jabs for ds).
Andrew Wakefield opened up this discussion for us all. I still feel grateful to him for it...and if he has that kind of conflict of interest - then so does every other doctor submitting for publication in ANY medical journal. Gggrrrr.

Hear hear Edam.

Actually I thought there was a recent report which appeared to support Wakefield's findings. So why are they pursuing him?

hmmm, well I think I would like to hear the evidence before I make up my mind. I suspect Dr Wakefield would welcome the opportunity to clear his name too. I have read/heard some pretty unpleasant things about him and this study and it would be good to hear them discussed in a proper forum. Subjecting children to "unnecessary and invasive investigations"m sounds particularly nasty I must say.
Having said all that, I think this debate is beyond any objective discussion. It reminds me of the Hutton Report - if the outcome is positive, it will be reported as a whitewash. If negative, it will be a conspiracy.
This is pretty scary though - "the number of measles cases has risen from 4,204 in 2003 to 56,390 in 2005" - does anyoen know where this comes from?? no reference of course. If that is true, then the strain on the health service will soon start to show.
Sounds unlikely though, much as I hate to doubt the bbc

Frekcle - it isn't to do with his findings in essence - it's about his methods and practices.

I think it's great.

Discussion (negative) of recent anti-MMR research
\link{http://www.badscience.net/?p=249#more-249\here}

He caused people no end of worry and scientifically dodgy. He needs to be held accountable

I thgink those cases are for mumps not measles..the report in the independent is bettter I think

Bluejelly, he's no more scientifically dodgy than 1000s of other researchers whose work is accepted for publication in peer-reviewed journals and who aren't being targetted in the same way - even when it is just as important (eg Seroxat).

Wakefield's big mistake wasn't doing the research, or even publishing it (and IIRC he did add a correction pretty damn quickly to the Lancet piece declaring his expert witness work). It was saying, at a press conference, that in his opinion, the safest thing to do until more research had been done to confirm or refute his findings, was look at providing single jabs. That's what he's being hung out to dry for. Maybe it was a stupid thing to say. But it's not something for which he should be drummed out of the profession.

agree with edam completely. This is a disgrace and forms the latest part of the campaign against Wakefield.

I am NOT saying he's right, btw. But that the campaign against him is not motivated by a desire for purity and the highest standards in scientific research. And uses the same tactics as campaigns against people who have been right.

Maybe we should all declare our interests in the debate? OK, I chose single jabs for ds, after doing a lot of research and consulting expert reviewers. Feel a bit embarrassed about it, tbh, as no weight of scientific evidence behind what I did. But worried that the tactics used against Wakefield were questionable and that it is at least possible that he did find vaccine-strain measles in the guts of these children. If I could have had ds tested to see if he had a leaky gut, then I would have been happyish MMRing. But I couldn't. And I'd take measles over autism any day - even though measles can lead to serious complications.

No-one has disagreed with Wakefiled's finding that a certain subset of children with autism have a novel bowel disease. That is pretty much confirmed. Very few people will treat the condition in the UK (Murch will), especially now Wakefiled has left, which is why a lot of people in the UK seeking treatment for their child's painful bowel condition now have to go to the USA.

The conflict in opinions arises when dicussing whether the MMR has caused this painful bowel condition (and autism along with it), or whether the measles virus etc is where it shouldn't be in these children because of the existence of the bowel disease- perhaps this group shouldn't be recieving MMR either way.

Wakefield continues to research this. The "unecessary treatment" was a lumbar puncture to obtain cerebro-spinal fluid. Incidentally vaccine strain measles virus was found in the majority of the autistic children with bowel disease and not in controls. I'd be interested to know why it was there, whatever the reason. Unecessary or not it revealed some interesting findings. The particularly unecessary bit was that these severely autistic children have to fly to the States to get the investigation performed as so many obstructions were put in place here.

Parents love Wakefiled because he will treat their children for painful conditions when the majority of the NHS says there is nothing that can be done and sends them away. If normal children had these agonising conditions there would be an outcry.

Incidentally Wakefield suggested switching to single jabs whilst further research was carried out investigating the MMR. Serious professional misconduct? What for suggesting a potentiall safer vaccination protocol. He never suggested not vaccinating.

The point that is repeatedly missed is that people who suspect a link between autism and the MMR believ that the MMR is safe for the majority of children. They are concerned about the 7% of autistic children who may have had their autism triggered by the MMR.

A teeny tiny number, so its OK to forget about them. Collateral damage.

'Bluejelly, he's no more scientifically dodgy than 1000s of other researchers whose work is accepted for publication in peer-reviewed journals and who aren't being targetted in the same way - even when it is just as important (eg Seroxat). '

Agreed, so chase all of them I say.

As a parent with a child with AS (not I believe caused by anything toher than genetics) I would take that over measles and its horrible (although I know how rare) complications any day.

Chasing down one man is very wrong, and I don't think acceptable or indeed useful. having strict penalties in place for all researchers who publish dodgy research is much better; don't let this chap off the hook, try and catch them all.

I beleived for ages I had caused Sam's difficulties by giving him MMR, until I read more, looked at my family (and myself) etc- it was horrible, thinking I had done it to my own child

What's wrong with his methods and practices? He treats autistic children when others refuse? Yes that's well dodgy.

or would it be acceptable for the NHS to refuse to treat your child with a painful bowel condition? The bowel condtion exists, it's a never seen befpre bowel conditon, no-one has disputed that. That's Wakefiled's main job- treating those children.

And before it comes up- the vaccine he was supposedly developing was not a rival to the MMR, it was being developed to treat children with the painful bowel condtion (autistic enterocolitis). That's what he does, treats children. As fewer than 10% of autistic children have the condition I doubt he would have got rich and wealthy on it.

Yes but peachyCalir, there are people whose children had huge seizures within days of receiving the MMR, lost previous gained skills and will never talk or live independently. The triggers leading to the development of their conditon are not necessarily going to be the same as the triggers leading to Sam's. There are huge dicussions going on at the moment as to whether AS and autism are even part of the same condition. Whether they are or not they are likely to triggered by a while different combination of factors. My son's autism wasn't MMR triggered either but I know people who were hospitalised within days of receiving the MMR, and are now autistic. I think its worth considering a possibility in those cases.

I think the media have a lot to answer for.
If they reported science properly, Wakefield's mistakes would not have done nearly so much damage.

OK have to work today but this is an extract from Richard Lathe's book. He developed a rabies vaccine ofr something, and is not anti jab. He gives the 7% figure as being a reasonable estimation of the number of children who appear to regress following MMR.

Anyway he says about Wakefileds original paper

"Wakefiled et al reported on a first series of 12 ASD children with loss of acquired skills, inclduing language, but accompanied by diarrhea and pain. All were found to have GI tract abnormalities, ranging from intestinal lymph nodes (lymphoid nodular hyperplasia LNH) to ulceration. Chronic colon inflammation (colitis) was seen in 11 and lymph gladn enlargement in the ileum in seven. Some aspects of this paper have been challenged, but not the presence or absence of GI abnormalities"

Even if Wakefield was completely wrong (and I'm not convinced he was)...

I don't think it's a good idea to go round striking research doctors off the record. If we do that, who will want to perform research? And then how will we learn anything? I think that medical research should be encouraged, not a case for professional negligence. Are all studies expected to support their hypotheses? That seems crazy to me.

Jimjams, I'm not disputing that at all- all I am sayiong is if there is (IF) enough evidence to proceed with this, then it should be applied to all. If there isn't wnough evidence, then it should be driopped- I am more concerned about the lack of monitoring for all researchers tbh (as a psychology undergrad last year, this was glaringly obvious).

The GMC do seem to be strict about who actually gets truck off, but I don't think a test case will hurt after all the furore around this. people do need to know what Wakefield did find- as you say, leqky gut etc- and what hedidn't, and that is shrouded in myth and hearsay atm for most.

Which mistakes would those be? None of his work has been disproved. In fact the research being done continues to show that a small proportion of autistic children may well have been MMR damaged. Certianly they've had a werid response to the MMR. (and that has been found in other studies such as autistc children from some reason are less likely to develop antibodies following rubella vaccination).

When I say to doctors "ds1 regressed following eczema hepreticum (ie a viral infection)" they nod their head sagely and ask some further quesitons. If I said "ds1 regressed following adminstration of a vaccine virus" (he didn't so I haven't said it but I know others who have) they would mark me down as a lunatic.

Why is it OK to say one, but not the other.

Although having said that it is actually OK to say the other. My friend's pead told her he believed that MMR was the triggering factor for her son's autism - but as well as being his paed now he treated him at the time of the reaction when they thought he was going to die. (Incidentally aged 7, non-verbal, in nappies, has unusual gait).