

The Facts In The Case Of Dr. Andrew Wakefield - joubert
http://tallguywrites.livejournal.com/148012.html

======
braintrust
Rather than merely putting this whole unpleasantness behind us and moving on,
I think the medical establishment (Doctors in particular) needs to take a
serious look at why the public was so ready to distrust them and assume the
worst.

Medicine in this country is a rotten business. Hospitals have shoddy billing
practices, routinely gouging their patients ($5 for a single Tylenol) and
giving them vague, indecipherable bills. Doctors engage in protectionism,
limiting the supply of doctors by restricting the accreditation of medical
schools, ensuring that they earn more than their counterparts in any other
developed nation by at least a factor of 2. Practicing physicians are also if
not outright in bed with, then certainly far too close to the drug companies.
I went to see a dermatologist a few years ago, and in the waiting with me and
the other patients were two attractive pharmaceutical reps waiting to see the
Doctor who owned the office. Doctors need to realize that trust must be
earned, and can easily be lost. As of late, they haven't been doing a whole
lot to deserve it. Until the medical establishment cleans up its act, you can
expect many more debacles like this one to occur.

~~~
pinko
Upvote for this. The reason people are so quick to distrust real life-saving
medical advice (e.g., about vaccinations) is because the medical world spouts
with implied certainty so much garbage that later turns out to be false--
nutritional advice being the most obvious example.

~~~
xsmasher
When you talk about "the medical world," do you mean popular news reporting on
medical topics? Populars news is frequently wrong or sensational (or both)
about science news. A small study about fat absorption becomes "What doctors
are saying about your diet - more details at 11."

That's not the fault of "the medical world." News orgs are no better prepared
to disseminate accurate medical news than they are accurate news about
computers and tech.

~~~
pinko
Much of the bad nutrition advice of the past few generations (e.g., the food
pyramid, "good" vs. "bad" fats, etc.) was regularly propagated by family
physicians. That is the very definition of most people's interaction with the
medical world.

------
nhebb
My favorite site on the subject:
[http://www.jennymccarthybodycount.com/Jenny_McCarthy_Body_Co...](http://www.jennymccarthybodycount.com/Jenny_McCarthy_Body_Count/Home.html)

------
philk
This is absolutely fantastic. The sooner we put this vaccine/autism bullshit
to rest the better.

~~~
rythie
Don't you see the wider message on the last page?

This destined to happen again, since journalists don't fact check, don't have
relevant expertise and the press favour sensationalism over accuracy.

~~~
jdminhbg
There's a lot of hate here for Wakefield's paper (much deserved) and for
mainstream journalists (also much deserved), but the fact that it got
published in the supposedly prestigious and rigorously peer-reviewed _Lancet_
goes by nearly unmentioned.

Journalists notoriously screw up their interpretations of scientific papers,
but that doesn't seem to be the case here -- they accurately reported what was
published in the _Lancet_. The problem was that it was published in such a
journal at all -- once that cat was out of the bag, the rumor had all the
credibility it needed.

~~~
nollidge
Surely you noticed the part of the article where Wakefield falsified data?
That the paper he submitted to the Lancet was at odds with the actual clinical
records at the hospital? And the fact that his damning financial connection
was not disclosed to the journal?

What is the journal supposed to do? They certainly couldn't have predicted
that a tiny 12-person study would blow up in the way it has. In the end, they
retracted the paper, which is exactly how it should have worked. Sometimes bad
papers get published--peer review can't catch everything.

~~~
jdminhbg
I noticed the part where Wakefield falsified data, as well as the part where
the author criticized his sample size and methodology... so why didn't the
journal's peer review process notice it? I find it hard to believe they
couldn't predict that a study concluding that a poorly-understood but
prevalent disease among children was caused by universal vaccination wouldn't
be big news. Why would the journal even consider publishing an article making
claims as big as Wakefield's on the basis of a dozen study participants?

The "in the end" where they retracted the paper was like six months ago,
right?

~~~
nollidge
> so why didn't the journal's peer review process notice it?

Because peer review, like every other human endeavor, is not perfect?

> I find it hard to believe they couldn't predict that a study concluding that
> a poorly-understood but prevalent disease among children was caused by
> universal vaccination wouldn't be big news.

But the study did not conclude that. The paper stated "we did not prove an
association between measles, mumps, and rubella vaccine and the syndrome
described". It reported interviews with the parents talking about MMR, but did
not conclude that itself. The conclusion was more about the relationship
between gastrointestinal issues and autism (also false, but less obviously
so).

No decent scientist would draw a sweeping conclusion like "autism is caused by
universal vaccination" from this study. One study--especially one so small,
with no controls and no randomization--does not demonstrate causation no
matter how significant the correlation. The Lancet study (false, but still
subtle enough) was misinterpreted due to Wakefield's spin machine and a
gullible media.

And to be honest, I have no idea why they didn't retract sooner. I do hold
them at fault for that.

------
jgrahamc
Just yesterday I saw a child in a local park who clearly had measles. It was a
pretty rare sight not long ago, but in the part of London where I live it's
trendy to not vaccinate your children.

~~~
tjmaxal
That's like saying it's trendy to sexually abuse your children. These are real
diseases that actually kill people. Appalling.

------
fr0man
Lumbar punctures for children in a study designed to strengthen a bogus
lawsuit? Yikes! That makes me angrier at the parents that volunteered(/were
paid for) their kids' participation than at the doctor. Though still pretty
angry at him, too.

------
allbutlost
Ben Goldacre on badscience.net has a lot to say on this sibject, including a
new related post today. [http://www.badscience.net/2010/05/a-staggeringly-
weak-interv...](http://www.badscience.net/2010/05/a-staggeringly-weak-
interview-of-andrew-wakefield-on-the-today-programme/)

------
jokull
So hard to still like Jim Carrey. He was great in "I love you Phil Morris".

~~~
rbanffy
He's an actor, not a scientific advisor.

He really believes this. The problem is that there is a bunch of people who
readily believe his medical advice over what a certified doctor would give.

~~~
gregwebs
Most certified doctor's aren't really doing much different than Jim Carey-
they have just chosen the CDC as their trusted source instead of the anecdotes
that Jim Carrey uses. So I would say people are choosing anecdotes over their
country's public health recommendations.

I think not trusting public health recommendations is a good thing given that
they are often not based on sound science. But unfortunately people are
turning to anecdotes instead of critically evaluating the evidence of both
sides.

~~~
tjmaxal
you seriously think that a man who has made millions as a professional liar
(actor) is just as good as a army of public health officials who are dedicated
to improving the lives of everyone?

I think not trusting public health recommendations is a good thing given that
they are often not based on sound science.

Where is your critical evaluation of your own statement? Where is your proof
for attacking a entire profession?

~~~
gregwebs
My point is that neither an actor, doctor, or government agency is a good
source of information: you have to look at the sources they are using (and
determine if they are accurately portraying the sources).

The only really good public health recommendation I can think of is to wash
your hands. Read the book Good Calorie, Bad Calorie if you want to learn how
dietary public health recommendations are not at all based on good science.

In the best case scenario our public health recommendations have generally
distracted us from the truth. I would probably get heavily down-voted for
discussing the worst case.

~~~
rbanffy
But wouldn't you then be trusting a book?

~~~
gregwebs
No, trusting scientific sources. If you see someone (including an author)
correctly interpreting scientific studies (and not cherry-picking them) then
you can think about trusting their arguments.

~~~
rbanffy
Still, you have to trust the book's author did not cherry-pick studies in
order to make his case for selling the book. This may go against his economic
interests.

That's a hard pill to swallow.

~~~
gregwebs
You don't need to put trust into any one book. Of course it would be foolish
to look at just one book or just books from one point of view on a subject. If
you look at the evidence from different sources site it will become apparent
who is cherry-picking and mis-interpreting. Maybe everybody is, and you make
up your own mind.

