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Email the BMJ Editor Asking These Questions RE: Andy Wakefield Editorial

Ask You're invited to email BMJ editor Fiona Godlee's office asking the following questions. Word docx file version HERE.  A respectful tone will encourage answers and be in the best interest of all of us. Thank you.

TO: fgodlee@bmj.com

FROM: (Your name here)

Dr. Godlee, I submit the following questions and would appreciate your response. Thank you.

1.    Do the BMJ editors stand by their 6 Jan 2011 editorial "Wakefield’s article linking MMR vaccine and autism was fraudulent" alleging Andrew Wakefield alone and unassisted committed research fraud?  

This relates to a 1998 Lancet medical journal "early report" calling for more research into a finding of a new bowel syndrome in children exhibiting autistic symptoms?

2.  The editors claim "Wakefield altered numerous facts about the patients’ medical histories in order to support his claim to have identified a new syndrome" and base this substantially on a comparison between early general family doctor records and what was reported in The Lancet early report.

Do the BMJ editors dispute that:

  • it was impossible for that to be done by anyone as they have alleged
  • it could not have been done by Dr Wakefield
  • none of the other 12 expert specialist medical professionals at The Royal Free Hospital London worked from or even saw those "patients’ medical histories"
  • those experts carried out their own investigations afresh 
  • Dr Wakefield faithfully reported the data and results provided by his other 12 expert professional colleagues

3.  If these matters are disputed, can the BMJ produce the data and results provided to Dr Wakefield by his 12 colleagues and demonstrate where The Lancet early report diverges?



4.  If the editors cannot produce evidence, do they now retract their editorial and the paper by Mr Brian Deer upon which it is based and which they also published?

5.  Can the editors confirm that neither they nor Mr Deer had sight of or access to the "prospective developmental records" of the 12 Lancet children [the "Red Books"].

These were used as part of the basis for detailed clinical histories investigating afresh early signs of disintegrative disorder.

6.  Do the editors agree that family doctors would not have considered "disintegrative disorder" nor looked for early signs.

7.  If the editors still stand by their story how do they account for the fact that those 12 specialist expert medical professionals read and reviewed the Lancet paper before submission for publication, approved Wakefield's report of their work and put their names to the paper?

8.  Do the editors accept that by accusing Dr Wakefield of fraud they are accusing all the other 12 experts?

9.  Do the editors also accuse the authors of the following papers of fraud for claiming to have found the same or a closely similar condition in autistic patients:-

Balzola F, Barbon V, Repici A, Rizzetto M. Panenteric IBD-like disease in a patient with regressive autism shown for the first time by the wireless capsule enteroscopy: another piece in the jigsaw of this gut-brain syndrome? Am J Gastro. 2005; 979-981. (Italian replication)

Balzola F, et al. Autistic enterocolitis: confirmation of a new inflammatory bowel disease in an Italian cohort of patients. Gastroenterology.2005;128:Suppl.2;A-303. . (Italian replication)

Balzola F, et al. Beneficial behavioural effects of IBD therapy and gluten/casein-free diet in an Italian cohort of patients with autistic enterocolitis followed over one year. Gastroenterology, 2006:30; suppl. 2 S1364 A-21. . (Italian replication)

Chen B, Girgis S, El-Matary W. Childhood autism and eosinophilic colitis. Digestion. 2010;81:127-9. (Canadian replication)

Galiatsatos P, et al. Autistic enterocolitis: fact or fiction? Can J Gastroenterol 2009;23:95-98. (Canadian replication)

Gonzalez L, Lopez K, Navarro D, Negron L, Flores L, Rodriguez R, Martinez M, Sabra A. Endoscopic and Histological Characteristics of the digestive mucosa in autistic children with gastrointestinal symptoms. Arch Venez Pueric Pediatr 69;1:19-25 (Venezuelan replication)

Horvath K et al. Gastrointestinal abnormalities in children with autistic disorder. J Pediatr. 1999;135:559-63. (US replication)

Krigsman A, Boris M, Goldblatt A et al. Clinical Presentation and Histologic Findings at Ileocolonoscopy in Children with Autistic Spectrum Disorder and Chronic Gastrointestinal Symptoms. Autism Insights 2010;2:1-11 (US replication)

 

Comments

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John Stone

Humanati

Thanks, but just to note that this article goes back to February and you can see Godlee's reply such as it is below.


humanati

Sent!

Good work!

Jenny Allan

More Lewis Carrol
`Do you mean that you think you can find out the answer to it?' said the March Hare.

`Exactly so,' said Alice.

`Then you should say what you mean,' the March Hare went on.

`I do,' Alice hastily replied; `at least--at least I mean what I say--that's the same thing, you know.'

`Not the same thing a bit!' said the Hatter. `You might just as well say that "I see what I eat" is the same thing as "I eat what I see"!'

Teresa Conrick

Ms. Godlee reports, "We are unaware of any peer reviewed paper replicating Andrew Wakefield's research"....

Yet there is:


The following peer-reviewed papers support Dr. Wakefield’s original findings:

Furlano R, Anthony A, Day R, Brown A, Mc Garvey L, Thomson M, et al. “Colonic CD8 and T cell
filtration with epithelial damage in children with autism.“ J Pediatr 2001;138:366-72.

Sabra S, Bellanti JA, Colon AR. “Ileal lymphoid hyperplasia, non-specific colitis and pervasive
developmental disorder in children”. The Lancet 1998;352:234-5.

Torrente F., Machado N., Perez-Machado M., Furlano R., Thomson M., Davies S., Wakefield AJ, Walker-Smith JA, Murch SH. “Enteropathy with T cell infiltration and epithelial IgG deposition in autism.” Molecular Psychiatry. 2002;7:375-382.

Wakefield AJ, Anthony A, Murch SH, Thomson M, Montgomery SM, Davies S, Walker-Smith JA.
“Enterocolitis in children with developmental disorder.” American Journal of Gastroenterology
2000;95:2285-2295.

Ashwood P, Anthony A, Pellicer AA, Torrente F, Wakefield AJ. “Intestinal lymphocyte populations in
children with regressive autism: evidence for extensive mucosal immunopathology.” Journal of Clinical
Immunology, 2003;23:504-517.

The following peer-reviewed papers replicate Dr. Wakefield’s original findings:

Gonzalez, L. et al., “Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic
Children with gastro-Intestinal Symptoms“. Arch Venez Pueric Pediatr, 2005;69:19-25.

Balzola, F., et al., “Panenteric IBD-like disease in a patient with regressive autism shown for the first
time by wireless capsule enteroscopy: Another piece in the jig-saw of the gut-brain
syndrome?” American Journal of Gastroenterology, 2005. 100(4): p. 979- 981.

Balzola F et al . “Autistic enterocolitis: confirmation of a new inflammatory bowel disease in an Italian
cohort of patients.” Gastroenterology 2005;128(Suppl. 2);A-303.

Lewis Carroll

'A cat may look at a king,' said Alice. 'I've read that in some book, but I don't remember where.'

'Well, it must be removed,' said the King very decidedly, and he called the Queen, who was passing at the moment, 'My dear! I wish you would have this cat removed!'

The Queen had only one way of settling all difficulties, great or small. 'Off with his head!' she said, without even looking round.

'I'll fetch the executioner myself,' said the King eagerly, and he hurried off.

Jenny Allan

In her response Fiona Godlee states:-

"As made clear in the article, the core data on which the findings were based were evidenced, except in the case of one child, by the transcript of a General Medical Council fitness to practise hearing which sat between July 2007 and May 2010."

Have I got this right Ms Godlee??? You are saying here that you based your BMJ allegations of fraud against Dr Wakefield and his co authors on transcripts of the 3 year GMC case against Dr Wakefield and his co accused Profs Walker Smith and Murch. These transcripts will have become available AFTER the verdicts announced in July 2010. The GMC trial evidence included BOTH Royal Free Hospital and GP casenotes for each child.

In her response Fiona Godlee continues:-

"In your questions, you suggest that Andrew Wakefield did not have access to GP records and therefore could not be responsible for discrepancies between those records and what was published in the Lancet in February 1998. The case we presented against Andrew Wakefield that the 1998 Lancet paper was intended to mislead is not critically reliant on GP records. It is primarily based on Royal Free hospital records, including histories taken by clinicians, and letters and other documents received at the Royal Free from GPs and consultants."

Fiona Godlee is NOW IMPLYING that Brian Deer's BMJ article ONLY used the Royal Free casenotes, which included the childrens' referral letters from GPs but CRITICALLY, did not include the minutae of the childrens' previous visits to their GPs for other medical reasons.

Mr Deer, who is NOT medically qualified, makes his own 'diagnosis' of pre MMR autism in a child taken to a GP with an ear infection, treated correctly with antibiotics. Mr Deer sites the child's 'apparent' deafness as being indicative of autism, but omits to mention the child had an ear discharge at the time. This information can ONLY have come from the GP's records NOT the Royal Free casenotes. Does Ms Godlee regard this kind of selective pseudo medical reporting as a true an accurate account in the BMJ, and yet use it as evidence of 'fraudulent' recording on the part of Dr Wakefield?? There's NO WAY that Dr Wakefield OR his colleagues had this information in 1998, the date of the Lancet article.

Ms Godlee CANNOT have this all ways. If she accepts that
Dr Wakefield did NOT have access to the GP's records in 1998, then she MUST accept that it is Mr Deer who is giving a 'fraudulent' account here.

Fiona Godlee

Thank you for your emails.

The BMJ stands by the article by Brian Deer and the linked editorial published on 5 January.[1] [2] The article, which was subjected to peer review and editorial checking, was based on enquiries carried out over some seven years, involving, among other things, interviews with parents of children enrolled in Andrew Wakefield's research. Four such parents are quoted in the article. As made clear in the article, the core data on which the findings were based were evidenced, except in the case of one child, by the transcript of a General Medical Council fitness to practise hearing which sat between July 2007 and May 2010.

In your questions, you suggest that Andrew Wakefield did not have access to GP records and therefore could not be responsible for discrepancies between those records and what was published in the Lancet in February 1998. The case we presented against Andrew Wakefield that the 1998 Lancet paper was intended to mislead is not critically reliant on GP records. It is primarily based on Royal Free hospital records, including histories taken by clinicians, and letters and other documents received at the Royal Free from GPs and consultants.

We draw attention to the finding of the fitness to practise panel, on which we are entitled to rely, that "the project reported in the Lancet paper was established with the purpose to investigate a postulated new syndrome and yet the Lancet paper did not describe this fact at all. Because you [Wakefield] drafted and wrote the final version of the paper, and omitted correct information about the purpose of the study or the patient population, the panel is satisfied that your conduct was irresponsible and dishonest."

Contrary to other suggestions contained in your emails, we made no allegation of dishonesty against Andrew Wakefield's co-authors, or indeed against anybody else. As the GMC panel heard, it was Andrew Wakefield who wrote the Lancet paper, using data which he anonymised, with little oversight by other authors. We confirm that under the uniform requirements for manuscripts submitted to biomedical journals all authors should be in a position to speak to data, but the evidence is that in this case they were not.

We are aware of recent claims made by Andrew Wakefield that "new documents have come to light" purportedly confirming his claims in the Lancet. The material he cites was presented to the GMC panel two and a half years ago. Andrew Wakefield was last year erased from the medical register and he has chosen not to appeal that decision. As indicated, the very many charges proven against him include dishonesty in his research.

We are unaware of any peer reviewed paper replicating Andrew Wakefield's research or confirming his claims to have identified a new syndrome of regressive autism and inflammatory bowel disease associated with MMR vaccination. With respect to gastrointestinal issues, we draw attention to an authoritative consensus statement published last year by experienced specialists in this field [3] and particularly to statement 4: "The existence of a gastrointestinal disturbance specific to persons with ASDs (eg “autistic enterocolitis”) has not been established."

With best wishes, Fiona Godlee, Editor in Chief, BMJ

References

1. Deer B. How the case against the MMR vaccine was fixed. BMJ 2011; 342:c5347 doi: 10.1136/bmj.c5347
2. Godlee F, Smith J, Marcovitch H. Wakefield’s article linking MMR vaccine and autism was fraudulent. BMJ 342:doi:10.1136/bmj.c7452
3. Buie P, Campbell DB, Fuchs GJ, et al. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus statement. Pediatrics 2010;125;S1-S18.

Jenny Allan

Well Done Joan.
Rebecca Fisher's 'Jabloonies' blog site is full of filth and profanity and it ill behoves the Editors of the BMJ to align themselves with the author of this kind of invective. Good for you being persistent about complaining to the BMJ about this.

I'm afraid the BMJ 'pulled' my published rapid response to Brian Deer's 3rd article after about a week. My response explained how Legal Aid is awarded and administered in the UK and the role of expert witnessess in litigation cases. Unlike Brian Deer I know EXACTLY what I am talking about regarding the UK Richard Barr MMR litigation case. My Grandson was one of 1000+ children attempting to obtain compensation for alleged MMR vaccine damage. As we all know Sir Nigel Davis on behalf of the Legal Aid Board was responsible for withdrawing the children's legal aid funding, effectively preventing a court 'proof' hearing of these childrens' cases. UK Court costs are prohibitive.

To put this mean and unreasonable decision on the part of the Legal Aid Board in context, the UK taxpayers presently pick up an annual Legal Aid bill of around £200million for failed asylum seekers attempting to prevent deportation from the UK. Apparently they can just keep on appealing against these decisions through the courts and at OUR expense.

Aasa

Joan,

The link you provided to Rebecca Fisher's website does not seem to work. The link I'm posting below leads to her fishy nonsense:
http://jabsloonies.blogspot.com/

Ughhh,

Aasa

Joan Campbell

This is what I sent her last night and lo and behold she published one of my letters in the BMJ today.
Dear Fiona Godlee

I am writing to complain about the way Dr Wakefield has been treated by you and your team allowing a person like Brian Deer and Rebecca Fisher to be allowed to write articles and rapid responces to your articles in the BMJ. Rebecca Fisher hosts the most disgusting website called www.jabsloonies.com
I have also written many times for the BMJ and my letters were always published, shame on you for being so biased against parents whose children have been damaged by the MMR vaccine
I am admin to Autism Mothers on facebook and we have over 15,800 members and that is just the tip of the iceberg.
Regards
Joan Campbell


Re:Being pro-vaccine safety does NOT make one anti-vaccine
• Joan Campbell, Carer/Teacher
Autism File
I agree with Lucija
My son was adversely affected by the MMR at 15 months. His story so mirrors many other parents stories by becoming non-verbal and having dietary, behavioural, learning, sleeping problems. To add to that my son has bowel and gut problems and at the age of 8 started to have seizures. We helped the seizures by going on a g/f and c/f diet plus supplements that he was deficient in. The seizures went away but came back with a vengeance at the age of 15. Now he is on medication to control his seizures but he is not able to get out of bed most days and I worry for his state of mind and health and that is why I am very serious about getting my message across to warn others of the dangers. I waited 14 years to hear my son say "Ma" and he is saying a few words now and can let me know if he wants something or not. Not all will suffer the way our children did from the adverse effects of the MMR but eventually the population will suffer if we allow un-safe vaccines. My son is 18 now, and I am not anti-vaccine I just want safe vaccines.
Competing interests: Mum of MMR vaccine damaged son
Submit rapid response
Published 3 February 2011


Jenny Allan

It seems that COPE will not look at a complaint until the the formal publication's complaints procedure has been exhausted.
In view of the fact that Fiona Godlee appears to be ignoring our e-mails, then I suggest we all re submit our complaints to the BMJ Advisory Board as below:-

http://resources.bmj.com/bmj/about-bmj/bmj-complaints-procedure
Definition
Our definition of a complaint is as follows:
*The complainant defines his or her expression of unhappiness as a complaint
*We infer that the complainant is not simply disagreeing with a decision we have made or something we have published (which happens every day) but thinks that there has been a failure of process—for example, a long delay or a rude response—or a severe misjudgment
*The complaint must be about something that is within the responsibility of BMJ editorial department – content or process
How to make a complaint
Complaints may be made by phone, email, or letter, ideally to the person the complainant is already in contact with over the matter being complained about. If that is not appropriate please email: complaints@bmj.com
Whenever possible complaints will be dealt with by the person to whom they are made. If that person cannot deal with the complaint he or she will refer it to a section editor or the deputy editor responsible for complaints.

AussieMum

Hopefully Australians can inundate BMJ with these questions too. I am sending my email off today.
Dr Andrew Wakefield has been receiving a lot of publicity in the last couple of weeks, (the wrong kind of course).
Its the usual "fraud" allegations and how much money he would potentially make with his own vaccine. See link below.

http://www.youtube.com/watch?v=jcY8QgOVdpE

John Stone

I have just emailed this to COPE:-

Can COPE publish a complete list of publications for which Dr Wager has provided her professional services?

In 2007 Dr Wager noted in BMJ Rapid Responses:

"I am a freelance writer and trainer, so my list of clients can change from week to week. My website is correct but a bit out of date (mea culpa) -- however, the purpose of listing customers is to give an impression of some of the companies I have worked for, rather than to show all potential competing interests. Over the years I haved worked for dozens of companies, and I would have to update my website almost weekly to include everybody I have ever worked for."

http://www.bmj.com/content/334/7586/208.full/reply#bmj_el_158265

But it is not clear why this would be onerous, or why in the name of transparency she does not do this. Moreover, this rather critically would not even begin to tell us which projects she is involved in.

John Stone

Jenny

Yes, I agree it is worth keeping up the pressure, so they cannot pretend nothing has been said.

Just to recap in 2007 Wager's name appeared as "academic editor" on Cochrane paper about ghostwriting but altered to "Wagner". The same paper recommended the toothless European Medical Writer's Association guidelines of which she was co-author with another industry insider Adam Jacobs. At the time Jacobs, himself, didn't even provide a client list and Wager said she could not keep hers up to date because she worked for so many people.

"I am a freelance writer and trainer, so my list of clients can change from week to week. My website is correct but a bit out of date (mea culpa) -- however, the purpose of listing customers is to give an impression of some of the companies I have worked for, rather than to show all potential competing interests. Over the years I haved worked for dozens of companies, and I would have to update my website almost weekly to include everybody I have ever worked for."

She adds:

"However, whenever I am involved with a particular project, I always ensure that any relevant competing interests are listed."

But it is hard to know what the latter means. Even now you will try in vain for the most part to detect any of the papers to which they have contributed their invaluable expertise. She also said her name was often spelt wrong.

http://www.bmj.com/content/334/7586/208.full/reply#bmj_el_158265

John

Jen

I phoned the BMJ's switchboard (number si on their website, 0207 etc) yesterday because the complaint i sent on 8 January and again on 28 January, have gone unanswered.
Godlee's PA said they're swamped, poor Fiona just *cant* keep up with her email (diddums!) Jane Smith is off sick this week, so she said she would print my emails for fiona to respond to directly. She said they cannot respond to all email because sometimes they get 100+ emails a day.
SPAM EM - and phone up. that's my suggestion.

I also contacted publicationethics.org
"Thank you for your email to COPE. Unfortunately, we are unable to consider a complaint against a journal until you have exhausted the journal (and/or publisher)’s complaints procedure and allowed a reasonable time for this process. For more information on how we handle complaints against a journal please see our flowchart here: http://publicationethics.org/files/u2/08_Editor_complaint.pdf
If, after attempting to resolve the problem through the journal / publisher’s system you still feel that the journal has not followed the COPE Code of Conduct (which members are required to adhere to), please do contact us again. You can view the Code of Conduct at http://publicationethics.org/files/u2/New_Code.pdf.
Kind regards"
Meh. Any othe ideas of how to get the ball rolling? I have a lot to say and i want to SAY it to someone - emails are too easy to ignore.

Jenny Allan

'Former chairs of COPE include Harvey Marcovitch and Fiona Godlee, co-signatories of the BMJ's allegations (Marcovitch also being chair of GMC panels). Presently it is held by industry ghostwriter Liz Wager'

John I agree, It's all very 'cosy' and we all appreciate the detective work of yourself and Jake Crosby in exposing all these 'webs of cronyism'.

Even so, COPE and the BMJ can hardly ignore an avalanche of public complaints, or if they DO,(and Fiona Godlee's PA has stated that she ignores most of her e-mails!!), we can make noises about this elsewhere, our elected representatives for example. THEY need our votes and in the USA only 52% of persons now believe that vaccines DON'T cause autism. The message IS getting through all the suppression.

John Stone

Jenny

This is a job for Jake Crosby!

Former chairs of COPE include Harvey Marcovitch and Fiona Godlee, co-signatories of the BMJ's allegations (Marcovitch also being chair of GMC panels). Presently it is held by industry ghostwriter Liz Wager: http://www.bmj.com/content/334/7586/208/reply

Wager is also on the board of the United Kingdom Research Integrity Office UKRIO (as lately was Marcovitch). UKRIO is supported by various interested public bodies but also the Wellcome Trust and the Association of the British Pharmaceutical Industry, which is affiliated to Medico-Legal Investigations, which assisted Brian Deer.

http://www.ukrio.org/sites/ukrio2/home/index.cfm

http://www.ageofautism.com/2011/01/harvey-marcovitch-and-brian-deers-investigation-the-lord-high-everything-else.html

UKRIO have already welcomed the BMJ's initiative. They state: "We have written to BMJ to clarify certain statements concerning UKRIO which appear in a recent editorial and article on research misconduct. Our letter can be found here and we are grateful to BMJ for allowing us to set the record straight. The editorial and article are fascinating reading and we welcome their publication as important contributions to raising awareness of research misconduct."
http://www.ukrio.org/sites/ukrio2/news/index.cfm

Wager's recent client list includess BMJ and GlaxoSmithKline:

http://www.lizwager.com/

Wager also sits on the BMJ Ethics committee, and is a long term associate of Godlee having co-authored a book 'How to survive peer review' with her and Tom Jefferson in 2002.

http://www.amazon.co.uk/How-Survive-Peer-Review-HOW/dp/B000W7X2RY/ref=sr_1_4?ie=UTF8&qid=1296744191&sr=8-4 She also used to work for Glaxo-Wellcome: http://publicationethics.org/about/council/harvey-marcovitch

Jenny Allan

I sent Dr Wakefield's questions to both COPE and the BMJ (Godlee) this morning. This was my complaint heading,(below). Feel free to copy any part of it when sending your complaints.

I wish to complain about the following articles recently published in the British Medical Journal. They represent an outrageous catalogue of lies and misrepresentations. Mr Brian Deer has NO medical or scientific qualifications and appears to have based his allegations on illegally obtained GP casenotes. These were NOT available to Dr Wakefield, his research team, or any of the treating clinicians at the time of writing the 1998 Lancet article. I enclose links to the BMJ articles which are the subject of my complaint and Dr Wakefield’s rebuttal.
Jenny H Allan
(Address and telephone No. available on request)

http://www.bmj.com/content/342/bmj.c5347.full
BMJ Editorial Godlee, Malcovitch et al

http://www.bmj.com/content/342/bmj.c7452.full
Brian Deer’s BMJ Article (1st of 3)

http://www.naturalnews.com/031117_BMJ_Dr_Andrew_Wakefield.html
Dr Andrew Wakefield’s rebuttal of the ‘fraud’ allegations.

Jenny Allan

It's perfectly possible to cut and paste these questions straight from this article into an e-mail. It's important for as many persons as possible to make their displeasure known to BMJ Editors Godlee et al.

Some supporters of Wakefield et al have also sent these questions to the Publication Ethics Committee (COPE) with a formal complaint against the BMJ for publishing Brian Deer's lies and misrepresentations, not to mention the slanderous allegations of fraud against Dr Wakefield and apparently his entire research team. This link takes you directly to a blank complaint form.

http://publicationethics.org/contact-us

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