Accountability

NY, NJ govs (one Dem, one GOP) clamp down on Ebola quaratine for returning health care workers, slam ever-changing CDC guidelines. That's because politicians are accountable to the people, unlike arrogant CDC. -0- Here's an idea -- if you've been...

How Mercury Triggered The Age of Autism

Conversation with the Authors of Plague

Autism Public Service Announcement

Canary Party Vaccine Court Video

A Glimpse into Autism

Meet Our Advertisers


Olmsted's Original UPI Series

  • The Age of Autism Tag

« Vaccines and Autism - What Do Epidemiological Studies Really Tell Us? | Main | Fox Boston: Autism Vaccine Link A New Investigation »

Time To Revisit Deer's Claims That Wakefield Fabricated His Findings: Part 2

London_Outside_350  By Martin Hewitt

In April AoA published the first part of a series revisiting Brian Deer’s claim in the British Medical Journal on 5 January 2011 [HERE] that the findings in the Wakefield et al paper 'Ileal-lymphoid-nodular hyperplasia' (Lancet, 1998; vol. 351, p.637) were fixed. It focused on the first claim that three of the nine children reported with regressive autism did not have an autism diagnosis [HERE].

Part two examines Deer‘s second claim thatDespite the paper claiming that all 12 children were “previously normal,” five had documented pre-existing developmental concerns”. This is done by examining the published UK General Medical Council transcripts of the fitness to practice hearing against Dr Andrew Wakefield and Professors John Walker-Smith and Simon Murch. We can then judge the accuracy, selectivity and interpretive license he applies to his evidence against Wakefield.

Deer identifies children 4, 8, 1 and 5 as examples of developmental concerns raised before MMR. The fifth child is child 11, a US citizen whose case was not examined by the GMC and therefore cannot be verified. We will examine statements he makes about each of the four children and then visit the transcript evidence to see if it supports his claims. Readers can see Deer's bullet-point claims in the BMJ paper. Each of Deer's quotes, including the endnotes, is given in italics. The validity of the claims is then tested against evidence from the GMC. All emphases below are added to the original.

CHILD 4 (born March 1987; measles vaccination April 1988; MMR February 1991)

Quote 1: “child 4...had developmental delays, and also facial dysmorphisms, noted before MMR vaccination...Wakefield played down problems, suggesting that early issues had resolved. ‘Child four was kept under review for the first year of life because of wide bridging of the nose,’ he reported in the paper. ‘He was discharged from follow-up as developmentally normal at age 1 year.’ But medical records, presented by the GMC, give a different picture for this child. Reports from his pre-MMR years were peppered with “concerns over his head and appearance,” “recurrent” diarrhoea, “developmental delay,” “general delay,” and restricted vocabulary. 

62. Dr Steel. Letter to Dr Sendall. 19 May 1988. Day 6 and Day 36.

63. William Tapsell. GP records. Day 6.

64. Dr Jackson. Letter to health visitor. 1988. Day 6.

65. ENT surgeon. Day 36. “At the age of two years and one month he apparently has a few single words only. He does not seem able to communicate his needs to his mother... Obviously I am more concerned about his increasingly apparent general delay. Mum was asking about this and although initially denying any problem, is obviously concealing quite deep seated worries about him being ‘backward’.”

Deer claims that developmental concerns were raised about child 4 before his MMR. If we take the facial dysmorphisms first, a letter from Dr Shabde (paediatric register) to the GP (General Practitioner), read at the hearing, says, “[Child 4] is nine months old and appears to be growing and developing normally.  As you may recall, the main worry initially was his small head which in fact is growing quite nicely between the 50th and 75th percentile.  His general growth appears to be satisfactory with his weight just below the 50th centile” (Day 6, p.57).

The paper’s authors did not see Dr Shabde’s letter and relied on the GP referral letter and the case history they took. Nonetheless the Lancet paper reports accurately that, “Child 4 was kept under review for the first year of life because of wide bridging of the nose. He was discharged from follow-up as developmentally normal at age 1 year (Wakefield et al, 1998 see above, p.638).

What Deer does not reveal is that child 4 had measles vaccination at 15 months, prior to MMR in February 1991. This significant fact was referred to in the Lancet paper: “[Child 4] had received monovalent measles vaccine at 15 months, after which his development slowed (confirmed by professional assessors). No association was made with the vaccine at this time. He received a dose of measles, mumps, and rubella vaccine at age 4·5 years, the day after which his mother described a striking deterioration in his behaviour that she did link with the immunisation” (Wakefield et al (1998) see above, p.638). Deer’s endnotes 62 to 65 above refer to doctors’ comments on developmental problems after child 4’s measles vaccination in March 1988. To be pedantic one might say that the measles vaccination is not the MMR. But for completeness, the paper referred to both immunizations noting slowing development after the measles vaccination and striking delay after MMR. It was at the latter point that parents suspected post-MMR regression.

Quote 2. “And although before his referral to Wakefield his mother had inquired about vaccine damage compensation, his files include a report of a “very small deletion within the fragile X gene”.  

66. Government vaccine damage payments unit. Request for information. 18 September 1995. Day 36.

67. Consultant geneticist letter. Day 6. “We are not sure whether this deletion is significant at all and certainly there is a very high possibility that it has nothing to do with [child 4’s] autism.”

Deer expressly refers in the body of his article to “very small deletion within the fragile X gene’ as a significant finding worth mentioning on early developmental delay. It is only when readers trawl down to endnote 67 that the finding is placed in context and its lack of relevance to developmental delay made clear.

CHILD 8 (born June 1993; MMR 27 January 1995)

Quote 1.  “Child 8…was also described in the Lancet as having overcome problems recorded before vaccination. ‘The only girl . . . was noted to be a slow developer compared with her older sister,’ the paper said. ‘She was subsequently found to have coarctation of the aorta. After surgical repair of the aorta at the age of 14 months, she progressed rapidly, and learnt to talk. Speech was lost later.’….Her doctors put the coarctation side by side with the delay and dysmorphism, and noted of her vocabulary that, before MMR at 18 months, she vocalised only  ‘two or three words.’”  

71. Wheldon Houlsby [consultant paediatrician]. Letter to Neela Shabde [community paediatrician] 17 February 1995. Day 29. “I was asked to see [Child 8] last year when there was concern about her development generally. When I saw her in clinic at the age of 10½ months I discovered that she had a coarctation, and referred her to the paediatric cardiologists. This was repaired surgically, and she is now well from this point of view. However concern about her development persists.”

72. For reference, according to Medline Plus, from the US National Library of Medicine and the National Institutes of Health, the typical 18 month old “Can say 10 or more words when asked”. According to the Early Identification of Developmental Delay and Disability project, funded by the state of California, at age 15 months, a child typically “uses 4-6 words”, and at 16-18 months “uses 7-20 words”.

73. Michael Rutter. Evidence to the panel. Day 37. “It is the kind of account that one often gets with an autism spectrum disorder. The fact that the child had only two to three words would make one uncertain as to whether this is a true bill or not, in that that is a very small amount of language to lose, but this is the kind of thing that one often sees so that the picture that comes out of all of these records is of a developmental problem that began early, involves language, involves some autistic-like features, quite a lot of hyperactivity, so that there does not seem much doubt that there was some sort of pervasive developmental disorder that could be regarded as falling on the autism spectrum at an earlier point.”

Endnote 71 refers to consultant paediatrician Dr Houlsby’s examination of child 8 after MMR and not ‘side by side with’ the earlier suspicion of coarctation of the aorta. This is what Dr Houlsby said about child 8 in May 1994 before MMR, at the first examination the previous year: child 8 sits very stably.  She does not crawl or roll.  Her mother is now happy with her general health.  She is vocal.  She is beginning to manipulate small objects appropriately.  She has mild eczema.... My impression was that she is a child who is developing within normal limits, but in whom I thought I may have found congenital heart disease as an incidental finding. I have arranged an EEG which was of very poor quality but probably within normal limits … I am therefore referring her to the Paediatric Cardiologists for a further opinion.” (Letter from Dr Houlsby, consultant paediatrician, to Dr Tapsfield (another practice GP), 24 May 1994, Day 29, p.2). Writing to the paediatric cardiac surgeon on 23 December 1994, a month before MMR, Dr Houlsby reiterates his view that child 8’s abilities “were not outside the normal” (Day 29, p.3). In summary, the child is assessed as normal apart from congenital heart disease.

Deer’s quote from Houlsby’s letter of 17 February 1995 (endnote 71) refers to an examination that raised developmental concerns shortly after the MMR given on 27 January 1995. The transcripts record the following summary by the prosecuting counsel examining the GP Dr Jelley. Referring to the same letter from Dr Houlsby to Dr Shabde (the community paediatrician), counsel says: “’Dictated 17 February 1995’, so a matter of a few weeks after the MMR. [Dr Houlsby] says, ‘She was recently admitted to the ward [on 13 February 1995] following a febrile convulsion in association with gastroenteritis...When I reviewed her in clinic recently I confirmed that she is globally developmentally delayed, functioning at about a one year level... There were no neurological abnormalities other than the developmental delay’” (Day 29, p.6).

So Deer’s quote refers to the consultant’s record of his examination of child 8 following a febrile convulsion and gastroenteritis 2 weeks after MMR and requiring emergency hospital admission.

In endnotes 72 & 73, Deer refers to the number of words child 8 spoke by 18 months before MMR at 20 months, suggesting early delay in language acquisition. Professor Rutter, the prosecution's psychiatric expert witness, advises that the number of words lost based on the number of words acquired in the first year is too small for an assessment of significant loss. However, contrary to his advice, he goes on to suggest that the loss of two or three words may be typical of developmental problems and autism. But no reference to the child’s vocabulary of “two or three words” is given in the GP’s examination on Day 29. Rutter’s reference to ‘two or three words’ is unreferenced and a “this is the kind of thing that one often sees” generalisation.

Several references are made in doctors’ letters to the mother's saying that child 8 had several words before her MMR immunisation which were subsequently no longer used. For example, the GP says to the hearing, "Several months later her mum said she had been looking at a video when Child 8 had a little bit of speech before the vaccination and she felt that that had reduced post-vaccination" (Day 29, p.4).

Quote 2.  “[B]oth the hospital and members of the primary care team involved with [child 8] had significant concerns about her development some months before she had her MMR.” 

74. Diana Jelley. Referral letter to Wakefield. 3 October 1996. Day 29

Again Deer persists with his claim that child 8’s developmental problems began before MMR. He refers to the GP’s referral letter to Dr Wakefield which, though claiming concerns prior to MMR, in fact referred to Dr Houlsby’s letter of 17 February 1995 (see above) noting child 8’s condition after the MMR, namely gastroenteritis and convulsions. But again other parts of the hearing transcripts cast doubt on Deer’s claim. For example, the prosecuting counsel asks Dr Jelley, GP: “What was the mother of Child 8’s perception of Child 8’s reaction to the vaccine?  Answer: I felt that the mother was concerned fairly soon after the vaccine – I think I saw her at home on a home visit shortly after the vaccination – she had had a kind of feverish reaction to it.  There obviously was no suggestion of delay at that point..."  (In fact, Dr Houlsby's letter of 17 February 1995 referred to her being "globally developmentally delayed"). The examination continues: Question: In terms of the more immediate reaction to the vaccine, you say that mum reported a fever.  Answer: Yes.  I remember seeing her at home and then I think she was admitted with a febrile convulsion shortly afterwards” (Day 29, p.4).

Contrary to Deer’s claim that child 8 had developmental delay before MMR, the following GP note records the concerns raised by the post-MMR convulsions: “MMR Jan 95: -> Grand mal convulsion Feb 95 2 weeks after MMR (no letter).  Never the same again.  Frequent diarrhoea, not infected but no tests done.  Eats well and gains weight” (GP note, May 1994, Day 29, p.5).

The Lancet paper accurately records this in Table 2, stating under column headed ‘Interval from exposure to first behavioural symptom’, “2 weeks”, and under ‘Features associated with exposure’, “Fever, convulsion, rash & diarrhoea”, so corroborating the GP’s account.

CHILD 1 (born January 1993; MMR 19 January 1994)

Quote 1: “One of the mother’s concerns was that he could not hear properlywhich might sound like a hallmark presentation of classical autism, the emergence of which is often insidious.”

Despite Deer’s suggestion of a hallmark presentation of classic autism evidenced in the child's earliest months, the GP’s record says differently: "4.11.93...Mum worried re hearing/wax in ears/? Discharge left ear…Reassured.” (Day 5, p.52). In other words, Deer is referring to the common childhood condition. The ‘hallmark’ was not an indication of a more insidious condition.

However, 13 months after MMR child 1 did see an audiologist who reported that “’Mrs 1 reported that Child 1 has around three meaningful words but his comprehension appears to be delayed....We are satisfied that Child 1’s hearing is adequate for normal development of speech and have discharged him from this clinic. (Day 5, p.53)”. After more than a year following MMR, this ‘hallmark presentation’ had now become a sign of developmental regression.

Quote 2: “Child 1 was vaccinated at 12 months of age, however...in the Lancet, the ‘first behavioural symptom’ was reported ‘1 week’ after the injection, holding the evidence for the lawsuit on track.  Step 1 to achieve this: two and a half years after the child was vaccinated, Walker-Smith took an outpatient history. Although the mother apparently had no worries following her son’s vaccination,  the professor elicited that the boy was ’pale’ 7-10 days after the shot. He also elicited that the child ‘possibly’ had a fever, and ‘may’ have been delirious, as well as pale.(81) “It’s difficult to associate a clear historical link with the MMR and the answer to autism,” Walker-Smith wrote to the general practitioner, with a similar letter to Wakefield, “although [Mrs 1] does believe that [child 1] had an illness 7-10 days after MMR when he was pale, ?fever, ?delirious, but wasn’t actually seen by a doctor.”

80. Anthea Barrow. Referral letter. 17 May 1996. “Mr & Mrs 1’s most recent concern is that the MMR vaccination given to their son may be responsible for the autism.” Day 5.

81. John Walker-Smith. Letter to Wakefield. 21 June 1996. Day 36.

82. John Walker-Smith. Letter Andrea Barrow. 21 June 1996. Day 77. Day 102.

Here, as elsewhere, Deer seems to assume that arriving at a diagnosis of autism is straightforward for parents and for doctors, ignoring the often lengthy retrospective process of arriving at a definitive diagnosis. He uses his simplified understanding of the diagnostic process to construct a narrative of Dr Wakefield ‘fixing’ the Lancet data in steps one to four. However the evidence shows otherwise. Professor Walker-Smith’s case history accurately records the parents’ belief that child 1 had a fever and was delirious seven to ten days after MMR. This information is entered in Table 2 of the paper, which states “1 week” under ‘Interval from exposure to first behavioural symptom’. The next column shows the ‘features associated with exposure’ as “Fever/delirium”.

Quote 3: “Step 2: for the Lancet, Wakefield dropped the question marks, turning Walker-Smith’s queries into assertions. And, although Royal Free admission and discharge records refer to ‘classical’ autism, step 3, the former surgeon reported ‘delirium’ as the first ‘behavioural symptom’ of regressive autism, with, step 4, a ‘time to onset’ of 7 days’.”

Walker-Smith’s use of question marks in his record of the parents’ statement reflects the passage of time between the first signs of regression following MMR and his examination of child 1 two and a half years later at the Royal Free, by which time autism had been expressly mooted. In compiling Table 2, summarising the case histories which members of the research team (but not Wakefield) took from parents, Wakefield distilled the essential points and removed Walker-Smith’s annotations. There was nothing underhand ‒ as Deer suggests ‒ in tabulating the bare information given by parents: the Lancet’s 'Early Report' paper summarises the information gleaned from the case histories and other clinical data.

The behavioural symptom ‘delirium’ accurately describes the symptom parents noted at about 1 week without knowing that their child would eventually be diagnosed as autistic.

Deer questions child 1’s diagnosis of regressive autism and bowel disease. However his admission to the Royal Free was for clinical investigations based on symptoms not diagnoses. The GP enclosed some consultant letters with her referral letter. Indeed, the GMC transcripts reveal the following records after MMR and prior to referral to the Royal Free, supporting the case for regressive autism and bowel symptoms:

  • GP notes for 1 November 1995 say “Autism”.  (Day 5, p.54)
  • Dr Hauck, Consultant Psychiatrist in Learning Disability, “On 7.3.96 I met Mrs 1, He suffers from loose stools on most days, she tells me.  From the Autistic Society she has received information about the benefits for some children of a casein-free and gluten-free diet” (Day 5, p.53).
  • GP’s referral letter to Walker-Smith at the Royal Free, 17 May 1996, “[Child 1] initially developed normally, reaching the normal milestones until he was about 15 months old.  He then regressed and has now been diagnosed as autistic” (Day 5, p.55).

The GP notes for 26 October 1994, written when child 1 had his 21-month check, 9 months after MMR and 19 months before his referral to the Royal Free, say, ‘“Little co-operation with psychomotor assessment.  Will not obey.  Tantrums when denied.  Does not seem to understand or express speech very much.  (cf probs with older brother).  Discuss with health visitor for check audio.  Re-assess in early 95.  Long chat with mum” (Day 5, p.52). So the early signs of developmental illness were evident to the GP within months of MMR and long before the child’s referral to the Royal Free.

Quote 4: “So herebehind the paperis how Wakefield evidenced his ‘syndrome’ for the lawsuit, and built his platform to launch the vaccine scare.

To construct his case that Wakefield fabricated the evidence, Deer must impute a motive as to why he would risk his reputation, namely that Wakefield wanted to discover a new syndrome to support the case of disabled children litigating against MMR manufacturers for vaccine damage. The discovery of a new syndrome is central to Deer’s case. However, he uses the term ‘syndrome’ (ie an association between two or more previously unrelated symptoms, namely autism and bowel disease) in two confusing ways: as a “brain-bowel syndrome” and as an “MMR syndrome”. But the evidence doesn’t serve Deer’s case. There is no reference in the Lancet paper to a “new syndrome” linking autism and bowel disease. All the references are to a hypothetical syndrome qualified, as befits a small initial case series paper, as follows:

  • “We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described.”
  • “If there is a causal link between measles, mumps, and rubella vaccine and this syndrome....”
  • “Further investigations are needed to examine this syndrome and its possible relation to this vaccine.” (all Wakefield et al, 1998, p.641)

CHILD 5 (born 10 December 1988; MMR 10 April 1990)

Quote 1: “Child 5, from Berkshire, aged 7 at admission, had received MMR at 16 months. The paper reported concerns at 18 months, but the medical records noted fits and parental worries at 11 months.”

 86. Child 5 was born on 10 December 1988 and received MMR on 10 April 1990. 

87. Geoffrey Shillam. GP records. 24 November 1989. Day 11.

88. Dr Williams. Letter to Dr Wilkinson. January 1992. Day 11, Day 36 “At one year he had convulsions which led to a further hospital admission but these appear to have been due to a high fever. From then on his parents noticed a difference in his development and feel that these febrile epileptic seizures continue to the present day... At 10 months of age he was saying mummy and daddy but then became very miserable and appeared to lose ground in his development after he had been in hospital.”

The Lancet paper Table 2 says under ‘Exposure identified by parent or doctor’: ‘none’. Therefore there was no evidence to fabricate. Deer suggests this is another case where there is no link between MMR and autism, but in this case the paper does not report a link.

Based on Dr William’s letter (see endnote 88) of January 1992 and written 21 months after MMR, Deer suggests that febrile convulsions and high fever at 10 months are evidence that concerns were raised prior to MMR. However, once again the transcripts for Day 11 show that for child 5 (as for all 11 children) autism and bowel symptoms were identified after MMR – and so this child was included in the Lancet 12:

  • Letter, 20 March 1991, written by Dr Sumitra (audiology consultant) to Mr Heyworth, ENT consultant and copied to Dr Shillam GP, “His speech is limited to two to four single words only.  I did not hear him say a word and found it difficult to establish a rapport.  I suspect there is a serious problem here” (p.36).
  • Letter from Dr Sumitra to Dr Shillam, GP, 9 January 1992: “autistic like features” (p.37).
  • Dr Wallis, consultant paediatrician writes on 31 March 1995 to Dr Shillam, “Diagnosis of autism” (p.44).
  • Dr Richer’s letter, 15 December 1995, to GP: “he may be suffering excess candida” (p.41).
  • Dr Shillam’s referral letter to Professor Walker-Smith, 1 October 1996, refers to “autism and childhood bowel problems” (p.48).

Conclusion

We have focused on Deer’s second claim that “the paper specified that all 12 children were “previously normal,” but that five had documented pre-existing developmental concerns.

He selects those parts of the transcripts that support the case for Wakefield fixing the data and ignores other parts that undermine the case. He ignores letters, reports and witness statements that show the children developing normally before the MMR. For example, he ignores accounts of child 4’s normal development at nine months (apart from the coarctation), and child 8’s normal development at 11 months. He does not mention child 4’s measles vaccination several years before his MMR. He misses the significance of child 8’s convulsions and gastroenteritis immediately after MMR. He sets down false trails that lead nowhere, such as child 4’s fragile X gene or child 1’s hearing before MMR. He confuses a syndrome associating autism and bowel disease ‒ presented as part of the case series paper ‒ with the ‘MMR syndrome’. He oversimplifies the everyday complexities and uncertainties doctors and parents grapple with in reaching an autism diagnosis.

Yet, contrary to Deer’s claim, the above documentary evidence from the GMC hearing points to the possibility that the children underwent developmental regression, in the form of autism and bowel disease, after MMR and not before. On balance a more extensive reading of the GMC transcripts than he provides upholds rather than undermines the findings of the Lancet paper.

Martin Hewitt, PhD is a former UK social policy academic whose research focused on the politics of health and welfare. He has written several books, chapters for edited  books and journal papers. Until recently he managed social policy and pensions work at the Institute of Actuaries in London. He has a teenage autistic son.

 

Comments

Feed You can follow this conversation by subscribing to the comment feed for this post.

The importance of the above posted information in this article cannot be understated.

When a clear and opposing viewpoint is given sufficient space to be shown, no reasonable person would hold the accusations to be the truth the whole truth ....

Every aspect of the BMJ's articles should be placed in full scrutiny. Not one aspect is not open to a more reasonable interpretation.

I strongly suggest that these articles are placed in correspondence to the following organisations.

The British Medical Journal

* asking for an independent ombudsman to investigate all aspects of the handling of this series of articles. Therefore editors Godlee et al standing aside.

http://resources.bmj.com/bmj/about-bmj/bmj-complaints-procedure

The British Medical Association

as above

http://www.bma.org.uk/employmentandcontracts/independent_contractors/managing_your_practice/complaintfaqs.jsp

Committee on Publication Ethics (COPE)

http://www.publicationethics.org/

This is the 'board' that undertakes investigation of complaints made against editors / journals and the way they undertake their duties as reporters of medical literature and research. (They do not undertake review of the actual content) They do investigate whether information has been presented in an objective and transparent manner.

Andrew Lansley CBE M
Secretary of State for Health

http://www.dh.gov.uk/en/Aboutus/MinistersandDepartmentLeaders/Ministers/index.htm

Simon Burns MP
Simon Burns, Minister of State for Health

Paul Burstow MP
Paul Burstow, Minister of State for Care Services

Anne Milton MP
Anne Milton, Parliamentary Under Secretary of State for Public Health

Lord Howe
Lord Howe, Parliamentary Under Secretary of State for Quality

European Parliament

http://europa.eu/pol/rights/index_en.htm

Huamn Rights and disability rights inclusive of parents and carers of children with a disability.


The big question is: What motivates this man? He has accused others in the past and seems to ejoy what he is doing. The answer must lie in the money trail.

When you've been following these events for a while it is easy to see at least some of the falsehoods in Deer's writings, but these articles help discern how completely Deer's "work" is driven by a false agenda. These articles are a valuable tool for those seeking the truth. Thank you!

From "across the pond":-

@ Jenny Allan

Correction:- The date was summer 1993 - one year later than stated in my original post - sorry, late night typo.

In our small community somewhere in the British Isles, the first autistic cluster was being diagnosed in the early 90s. My ASD child joined that existing cluster in the summer of 1993. As far as I can tell, the so-called "cluster" has continued and can no longer be described as a "cluster" (accurate figures are not available locally). However, in the last year or so I've been told by several teachers, "we don't know where they're coming from" (referring to the numbers of ASD children).

Further to the situation with health visitors, it should be noted that even special needs teachers did not necessarily have the relevant experience of teaching ASD children, particularly those with average or greater than average intelligence. Yes, that's a generalization but I'm assured by teachers that my observation was/is accurate.

From time to time I've wondered why, if the doctors won't (don't want to) believe what the parents of ASD children are telling them, they won't (don't want to) believe what the teachers are telling them? No, I don't really expect an answer. Maybe American teachers could be a source of so-far hidden support?


Thank you ElizaCassandra for sharing your UK health visitor's expertise with your own child; this is certainly NOT a 'side issue'.:-

"So, an experienced health visitor was already proficient in the early identification of autism at eighteen months of age in the summer of 1992."

I honestly WISH that our UK doctors, scientists and health visitors would speak out and protest vigorously about Brian Deer's vile slurs on their professional integrity and performances. The BMJ 'Secrets of the MMR scare' has plumbed the depths of journalistic and 'media muck raking', (Deer's OWN description of his style of investigative journalism).

Deer's first article 'How the case against the MMR was fixed' and the accompanying editorial 'Wakefield's article linking MMR vaccine and autism was fraudulent' (Godlee, Marcovitch and Smith,05-01-11), caused a furore in the US media involving a metaphorical Wakefield 'lynching' on TV by Anderson Cooper. This resulted in a clamour of US calls to have Wakefield jailed, or even sent to the electric chair!! A few years ago the metaphorical lynching would have been a REAL one!!

In contrast, Poul Thorson's indictment for misappropriating millions of dollars of US taxpayer's money and Autism Speaks charity cash, intended for yet another epidemiological vaccine 'debunking' study, has elicited not one word of TV media approbation, exept for Reuters and an Atlanta newspaper, which noted Thorsen's palatial Atlanta house, and Harley Davidson motobikes and expensive cars etc!!



Martin is to be applauded for all the work that has gone into sifting through the details of this case. It is disgraceful that relevant authorities did not check up on what Brian Deer was reporting to assess their accuracy - or even worse - chose to ignore the discrepancies to further their own agenda. After some of the revelations this week from USA, this is an extremely well-timed article Martin. Thank you!

From "across the pond":- On a side issue, our health visitor knew my (later diagnosed) ASD child from birth in 1990. The standard developmental checks were carried out and passed with flying colours until the eighteen month check ... which, some time later, she admitted had been "very borderline". At that check, which identified a loss of acquired abilities, she stated that, if my child's speech did not return (about ten words had been lost during the month after MMR), there were tests that could be carried out. Long story cut short, those tests were carried out just before 2 1/2 years of age and my child given a provisional diagnosis of autism. So, an experienced health visitor was already proficient in the early identification of autism at eighteen months of age in the summer of 1992.

Jenny I imagine there must have been thousands of health professionals up and down the land squirming at Deer's truculent and uninformed pronouncements in that programme, though no doubt it was more than their jobs were worth to say anything. Significant to note that there was almost a complete absence of supportive comment for Deer and the BMJ from UK health professionals, particularly doctors, in BMJ's own columns. While most will have reckoned that they would never have time (or the encouragement) to disentangle all Deer's sources certain fundamental aspects must also have seemed decidedly fishy.


John says:- "while Deer can go and waffle in an authoritative manner on the radio (and very offensively about 'baby books') he is not being made to answer in BMJ on his erroneous interpretations of facts."

As part of his radio pontificating about 'baby books' on the BBC 'Science Betrayed' programme, Deer was also extremely offensive about health visitors, whom he plainly regards as being untrained and ignorant about autism. (In fact health visitors ARE trained to look out for signs of child developmental delays and abnormal behavioural signs, including autistic behaviours). This shows the complete ignorance of Brian Deer about all matters pertaining to child developmental issues and illnesses. If I was a UK health visitor I would feel very insulted by Deer's nasty comments about this highly respected profession.

At one point Deer also accused Dr Wakefield of 'ignorance' about autism. This was a 'bit rich' even for Brian Deer, since Dr Wakefield was employed by the Royal Free Hospital as a research scientist, specialising in inflammatory bowel disease, NOT a clinician, and had no clinical access to patients. Autism is a complex condition and quite difficult, even for expert psychiatrists, to diagnose in young children. It is an IMPOSSIBLE conditon to diagnose in a test tube!!

Brian Deer plainly spent a great deal of time picking over the minutiae of that Wakefield et al 1998 Lancet article looking for discrepancies!! However, Deer does NOT appear to have actually UNDERSTOOD the article itself; perhaps the technical language was too difficult for him to comprehend.

Included in the Patients and Methods section is the following paragraph:-

"Neurological and psychiatric assessments were done by consultant staff........Four children did not undergo psychiatric assessment in hospital; all had been professionally assessed elsewhere, so these assessments were used as the basis for their behavioural diagnoses."

In other words, properly qualified and experienced persons, trained within the fields of neurology and psychiatry, assessed the Lancet 12 children and provided the Neuropsychiatric Diagnoses tabulated in page 3 of the paper. Dr Wakefield played NO PART in these diagnoses, and neither did Professors Walker Smith or Murch.


The neurodiverse are predictably silent on this... where's Reibel, where's Leitch, where's Seidel?

There's really no defense for Deer here. And since the neurodiverse cannot refute or debate this... their continued attacks against Wakefield, and continued support of Deer, therefore is highly suspect and smacks of industry bias.

Martin - keep up the good work, this analysis will be invaluable when the story is in the headlines next time around.

Isabella - I have had to deal with similar conduct in the investigation of my case, the difference being it has not been splashed over worldwide media. To have a little $%!& like Deer with his paws all over your medical history must be hard to bear.

Debra

It would be bad enough if Deer was just offering an interpretation, but he and BMJ are making allegations of fraud.

John

It seems that Mr Deer has purposely left out the facts and i wonder how he has been able to get away with this , thankyou Martin for clarifying the situation , the parents must be absolutely livid that this man appears to hold so much information on their children , i doubt this is within the law , and again i make reference to the fact that Mr Deer lied about his real name to gain entry to the house of an Autistic child , this approach is the lowest of the low , and know we see that Autism is once again in the news ITS NOT GOING AWAY MR DEER

Isabella

That is of course typical of how gaps in the documentation were spuriously used as evidence against the doctors, as for example the documentation that the children were investigated under ethical permission 162-95 rather than 172-96.

John

Deer had no access to the red books of the children.
The GMC tried to make out that one of my boys was not vaccinated at all with the MMR vaccine. What they do not know is that it is stated in his red book that he had the MMR vaccine. I also have the batch numbers of the MMR vaccine given to both my boys.
I have sent e-mails to the BMJ asking questions about Brian Deer's investigations on my boys and still have had no reply. Is this how the BMJ treat the 'Lancet children' by not giving the parents a voice? The very ones they say they are trying to protect. The only people they are protecting is Brian Deer and themselves.
Martin, well done on all your hard work with this article. With parents like you the truth will out.

Keep up the good work Martin, Brian Deer will pay eventually for all the damage and mis information that he keeps pushing out.
All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.
Arthur Schopenhauer
German philosopher (1788 - 1860)

Martin, it is people as yourself that deserve all the credit, and I thank god that there are many more in the autism community like you.

Jenny,

Yes, and the scandal is that BMJ will not allow a proper discussion, and won't publish Martin's criticisms. Most significantly, while Deer can go and waffle in an authoritative manner on the radio (and very offensively about 'baby books') he is not being made to answer in BMJ on his erroneous interpretations of facts.It is completely outrageous when making such grave charges that they should seek to limit discussion.

Moreover, as we know Godlee was crucially forced to state as a result of pressure from AoA readers that “The case we presented against Andrew Wakefield that the 1998 Lancet paper was intended to mislead is not critically reliant on GP records”, so we can reasonably ask, why bring them up? why make them the centrepiece of an article alleging fraud?

I also think everyone ought to thank Martin for his incredible work trawling through the 6 million word transcript. It was surely part of the cynical calculation of BMJ that it would take months to catch up with all the omissions and innuendos: while the world's media placed its reliance on the journal's reputation. Shame!

John

An excellent analysis by Martin Hewitt, and his article confirms the GMC evidence about the children's medical histories, (much of which was NOT available to the Royal Free clinicians and researchers), actually SUPPORTS the accounts of the children's post vaccination regression as reported in the Wakefield et al 1998 Lancet paper.

The three year £7million GMC 'trial' of clinicians Professors Walker-Smith and Murch and research scientist Dr Wakefield, also did not find the 1998 Lancet paper was dishonestly reported. although obtaining a transcript of the convoluted proceedings would cost around £100,000 and would probably take until the next decade to read!!

Dr Wakefield was found 'guilty' of failure to disclose a conflict of interest, (although this did not apply to members of the GMC panel or chief expert witness Sir Michael Rutter!) Professor Walker-Smith was found guilty of failure to obtain the correct 'ethical' permission for obtaining research specimens. Professor Murch was cleared of all charges.

We should all be extremely concerned about the 'raison etre' for the recent Brian Deer series of BMJ articles 'Secrets of the MMR scare'. Fiona Godlee, BMJ Editor has admitted 'commissioning' the three articles from Deer in advance, but she has NEVER stated WHAT EXACTLY was 'commissioned' or WHY!! Dr Godlee, after a lot of pressure from AoA and others was dragged 'kicking and screaming' into publicly admitting that the BMJ relies upon pharma funding, including MMR manufacturers GSK and Merck.

Dr Wakefield is often blamed, very unfairly, for a dip in MMR vaccination rates, resulting in 'outbreaks' of 'dangerous' measles. In the UK there have been two child deaths attributed to measles, although the children had other serious co morbidities and in one case it was not certain that measles was the primary cause of death. Dr Wakefield, has often been accused of virtually murdering these children, neither of whom could have been vaccinated anyway due to their medical status!! Against this, there have been many infant deaths following the MMR vaccine but the vaccine has NEVER been 'officially' implicated in these deaths!!

A recent BBC Radio 4 programme 'Science Betrayed' was obviously sourced using Brian Deer's recent BMJ articles. Fiona Godlee stated on the programme that Brian Deer 'helped' the GMC with their investigation!! What an admission, in view of the fact that Brian Deer has NO medical or scientific qualifications whatsoever!! Science Betrayed indeed!! Godlee went on to state, correctly, that the GMC did not find the Lancet article was 'fabricated'; this was Brian Deer, who infamously stated on the same programme that Dr Wakefield was an 'incompetent doctor' because he used the 'baby books' instead of the GP records when compiling the child histories!! (The Lancet paper CLEARLY states that 11 of the children's medical histories were compiled by Professor Walker-Smith; the 12th child came from the US and had no UK previously compiled notes). The 'baby books' are what Deer called the children's developmental records or 'red books'. Deer had NO access to them at all.

Verify your Comment

Previewing your Comment

This is only a preview. Your comment has not yet been posted.

Working...
Your comment could not be posted. Error type:
Your comment has been saved. Comments are moderated and will not appear until approved by the author. Post another comment

The letters and numbers you entered did not match the image. Please try again.

As a final step before posting your comment, enter the letters and numbers you see in the image below. This prevents automated programs from posting comments.

Having trouble reading this image? View an alternate.

Working...

Post a comment

Comments are moderated, and will not appear until the author has approved them.