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Jake Crosby Challenges BMJ Editor-in-Chief Fiona Godlee

Godlee By Jake Crosby

I couldn’t believe it. Yet there it was on Leftbrain/Rightbrain – news that Fiona Godlee would be giving a talk at the NIH entitled “Lessons from the MMR Scare.” When I clicked the link to the event on the NIH website, it confirmed that LBRB was actually right about something: Fiona Godlee, editor-in-chief of the British Medical Journal, was coming to the U.S. (Thanks Matt!)

So on September 6th, I took the Metro out to Bethesda, Maryland to participate in Dr. Godlee’s discussion, co-sponsored by The Fogarty International Center and the National Library of Medicine: two component organizations within NIH.

The person who introduced Fiona Godlee was Dr. Roger Glass, director of the Fogarty International Jake Godlee Center. I was interested to learn that this was not the first time Dr. Godlee had been at the NIH, seeing photos of her with Dr. Glass from her last visit five years earlier.

During his introduction, Dr. Glass described his own work on rotavirus, which spanned, as he put it, “much of my career.” Indeed, he had helped work on rotavirus vaccine development with millionaire vaccine industrialist Dr. Paul Offit. Yet, Dr. Glass said he was not interested in vaccine adverse events until the first Rotavirus vaccine was “crippled” by intussusception, as if the vaccine was the victim and not the children it harmed. It was at that point that he “realized there was a huge anti-vaccine movement outside” – more like the intestines of children turning inside out – including those of the infant son of my former professor, Michael Willrich.

When Dr. Fiona Godlee stepped up to the front of the room, almost everyone applauded. I couldn’t bring myself to clap for her, so I didn’t.

Her talk was hardly anything new – mostly just a regurgitation of practically every smear that’s ever been made against Dr. Andrew Wakefield within the last eight years. She did, however, make one startling admission when stating her three feeble excuses for failing to disclose her journal’s pharmaceutical connections.

First she argued that it “did not occur to me” to disclose because she did not see Brian Deer’s articles as “pro-vaccine” but “anti-fraud.” This, however, is directly contradicted by the accompanying BMJ editorial she cosigned with deputy editor Dr. Jane Smith and associate editor  Dr. Harvey Marcovitch – and in fact was the lead author of – which concluded (boldface mine):

The Lancet paper has of course been retracted, but for far narrower misconduct than is now apparent…leaving the door open for those who want to continue to believe that the science…still stands. We hope that declaring the paper a fraud will close that door for good.

That doesn’t sound “anti-fraud,” it sounds anti-Lancet paper.

Dr. Godlee’s next excuse was a complete oxymoron. She said did not see the pharmaceutical connections as conflicting because the Merck-Univadis partnership was with BMJ Learning and the pharmaceutical funding was for the BMJ Group Awards, claiming neither was part of BMJ.

I simply don’t follow her logic at all. Anything that’s part of the BMJ Group revolves around and would therefore be a part of the BMJ, hence the name.

Finally, the last excuse she gave for her failure to disclose her journal’s competing interests with Merck and GlaxoSmithKline (GSK) earlier this year was:

“And the third which I didn’t say at the time because I was afraid it would make me look stupid is I didn’t know that MMR was made by GSK or Merck; I just didn’t happen to know that.”

Well, she certainly looks “stupid” now! How could the BMJ editor-in-chief who had defended the MMR vaccine for at least seven years not have known who made it?

At the end of her talk, Dr. Godlee concluded by hijacking a quote from Albert Einstein:

“The right to search for the truth implies also a duty; one must not conceal any part of what one has recognized to be the truth.”

I couldn’t have said it better myself.

Needless to say, my arms remained crossed when others clapped.

Throughout the question and answer session, I patiently waited my turn, until finally called on by Dr. Glass (you can view the exchange on the 54:00 of the NIH Videocast):

“Yeah? Introduce yourself?”

“Hi, my name is Jacob Crosby with GW School of Public Health and Health Services. I just want to…you made a number of statements here regarding Andy Wakefield who is not here to defend himself against them, but…there are a couple problems that I…that I saw with Brian Deer’s claims. He claimed that three children weren’t autistic because the have Asperger Syndrome, children 6, 7 and 12, but Asperger Syndrome is a form of autism. He said that the bowel pathology results were fraudulent because they don’t match up with the routine pathology results, which is only the first step in the tertiary diagnostic process. The end result from the routine pathologist’s report…is not accused of fraud, to my knowledge…matches up with what was in the paper. And…furthermore, all the five children – or five to six children – that he claimed did not really regress or have some sort of deterioration after the MMR vaccines…those five children…were all developmentally normal except for one kid who had developmental problems due to an unrelated preexisting condition. And…(people in the background started to mumble)…they all faced developmental regression after the vaccine. So…

At that point – about a minute and a half into my question - I was interrupted by Dr. Glass:

“Give us your question!”

I continued undeterred:

…I’m just curious because-I’m curious, why…you’re talking about - there needs to be oversight, in fraud - but it seems like, Brian Deer here, committed fraud.”

For about five seconds, the room was dead silent. An awkward grin was left on the face of Fiona Godlee, nervously nodding her head. However, what she said was the usual:

“Okay, a lot of the things that you’re…itemizing have been raised on web comments and Brian, I think, has responded to them. I mean, I can give you my response…”

“No, he hasn’t,” I said. Brian Deer has never responded in the BMJ to the allegations, and blogs like Leftbrain/Rightbrain  and Respectful Insolence hardly count, if those are what Dr. Godlee was referring to.

“Well, I think you’ll find he has,” she replied.

She continued, “The three…three children with Asperger’s Syndrome…he makes the point that the paper is about regressive developmental delay…so these children were being represented as people with regressive autism and Asperger’s…”

I responded:

“Right and they did have, they did regress, the two children – children 6 and 7 – they, they did have seizures before MMR vaccine, the paper was only talking about their developmental progress, which regressed.”

She didn’t have a response:

“Okay, I don’t know…I’d be happy to talk after about that case, we can discuss that after…”

Why not now? I wanted to point out that Brian Deer’s allegations of regression don’t match up, either:

“Okay fine, but I’m just saying…”

But she was moving on.

Then she backed up one of Brian Deer’s most egregious and verifiably false allegations of fraud:

“…I just want to talk about briefly…the…pathology. I think what’s really important to recognize is that what was reported in the methodology of the paper was that this was a planned protocol approach…with these four pathologists looking at it but that wasn’t in fact the case. What happened was that the…hospital pathologist looked at them…at the pathology slides and found almost no evidence of any…”

I corrected her:

“Oh, no, that was, that was the routine pathologist. When it was followed up with Amar Dhillon, that was, there was…he’s an expert in that field, there–that’s when they found evidence.”

“The Lancet paper did not report it in that way, and I can explain that later…”

She has all the answers “later…” I wasn’t going to let her get away with obfuscating the pathology results, either:

“…Yes, it did.”

 At that point, Dr. Glass pulled Dr. Godlee out of the fire:

“L-Let’s go on. Let me move on and we can continue this afterwards if you want.”

“Afterwards” – as in – out of earshot of the audience and the NIH recording devices.

He then quickly changed the subject, asking Dr. Bruce Gellin – head of the National Vaccine Program Office – who sits on NVAC with  Dr. Marie McCormick about the “consequences” of the Wakefield paper. Dr. Gellin, looking surprised, played along, asking a two-minute long (uninterrupted) question.

Later, a UK medical student named Marcus stepped up to the microphone, and asked another two-minute long question - also completely uninterrupted - unlike mine – which included the following comment:

“You mentioned the whole idea of one man toppling the entire institution. It’s actually, clearly, Mr.-Dr. Wakefield was really very skilled in this aspect of communication. Indeed, he was able to sell a lie to everyone else – and – everyone else was not skilled, was not able to defend that lie, or, or defeat that lie.”

Dr. Godlee agreed: “He’s a clever man.”

I just shook my head when I heard that. It’s certainly much easier for folks like Dr. Godlee to propose the medical mind control theory about Dr. Wakefield than to examine the evidence before them and consider that he may actually be right. It is almost as if they are trying to scare people into dismissing Wakefield for fear he’ll somehow brainwash them. This was pretty much the whole premise behind a New York Times article written earlier this year by Susan Dominus - friend of Seth Mnookin's Uncle Bob.

After the discussion, I walked over to Dr. Godlee and waited for her to finish speaking with the other attendees. While I was waiting, I was approached by Dr. Glass, who asked in a friendly manner:

“Are you a student at GW School of Public Health?”

“Yes.”

“Great, so what do you study?”

“Epidemiology,” I replied.

 “Are you in the MPH Program?”

“Yes.”

“Who is the head of the epidemiology program?”

“The program or do you mean the whole department?”

“The whole department.”

I said the person’s name and then I later realized Dr. Glass was probably testing me to see if I really was connected to the GW School of Public Health and Health Services as opposed to just wearing a t-shirt with the school’s name on it.

As I was waiting for Dr. Godlee to finish, I checked the time on my cell phone. Probably aware she had been taking awhile, she turned to me and said:

“Don’t go away.”

Finally, she turned and shook my hand, and that’s when our debate continued.

I told her she contradicted herself in the lecture, having told me during Q/A that Deer merely said the children diagnosed with Asperger Syndrome did not have regressive forms of autism, when in fact – as Dr. Godlee read out loud during her lecture – he argued the three children did not have autism diagnoses at all.

She then invented a new claim that they did not have Aspergers diagnoses by the time the paper had been published.

I replied that they did.

So she changed her argument yet again, instead claiming that Asperger Syndrome was not classified as an autism spectrum disorder at that time.

Asperger Syndrome was always part of the autism spectrum! When I made this clear to her and that in 1994 – four years before the publication of the Lancet paper – Asperger Syndrome was included as an autism spectrum disorder in both the Diagnostic Statistical Manual and the International Classification of Disease; she had nothing left to say.

She also did not further explain her claim that the methodology behind the expert pathologist’s report was not properly explained in The Lancet, as she said she could.

Having told her I write for Age of Autism, she said:

“I think Age of Autism is mostly pseudoscience.”

I replied, “I think your defense of MMR is mostly tobacco science.”

“Oh, okay,” she said in embarrassed laughter, “I haven't heard that one before!”

I responded, “Like the Kaye et al. article you cited at the beginning of your lecture, your colleague Tom Jefferson threw it out in the Cochrane Review. It was also funded by pharma and never took into account the age at which children were vaccinated, which according to another study from California decreased progressively during that same period.”

At that point, if there were crickets in the room, I think you’d be able to hear them go: *chirp*chirp*

On the topic of disclosure, she was equally erroneous, but at least somewhat flexible.

Me: You disclosed your awards sponsorship from Merck and GSK but not your journal's Univadis-Merck tie.

Her: Oh yes, we disclosed all of them; we disclosed our income from Merck and GlaxoSmithKline.

Me: But an endless educational grant from Merck's information arm isn't really the same as general income.

Her: The Merck connection we disclosed was for Univadis and the GSK connection we disclosed was for the award.

Me: But Merck also funds an award! I think you should clarify this so that readers will know you aren't just acknowledging your Merck award-sponsorship as a conflict of interest, but also your partnership with Univadis.

Her: You're right; we will post a clarification.

I also backed her into a corner over why she didn't publish John Stone’s letters to the BMJ’s rapid response section, she replied:

"We post A LOT of things from John Stone."

“Not everything," I responded.

Her: "Well, we don't post disrespectful letters.

Me: “John Stone is very polite.”

Her: “John Stone is usually polite but not always.”

Me: “I’ve never seen any rudeness from him.”

She never provided any examples of John Stone being rude in his unpublished BMJ letters. I certainly saw no evidence of rudeness in any of his BMJ-censored letters published on Age of Autism.

On disclosing the BMJ-pharma links under Deer's articles, she wasn't as up front:

“It's my conflict of interest, not Deer's”  - she told me.

“The BMJ commissioned him,” I replied.

“Yes, but it's my responsibility as the editor.”

“The fish rots from the head.”

“Oh, wonderful…” she said in more embarrassed laughter.

“It's a Russian proverb,” I clarified to her.

“Well, if we would publish an article by you - we wouldn't - but if we did, I as the editor would be responsible for my journal's connections, not you.”

So, because she would supposedly hold me to the same standard as Brian Deer if I published anything in the journal - even though the journal wouldn't publish it - therefore Brian Deer should get away with no COIs disclosed under his articles, even though he was commissioned by the journal to write them.

I delved further into how he was the original complainant. Dr. Godlee argued he wasn’t, claiming the GMC sent a letter that proved otherwise. To quote Matthew Lohn, the GMC partner who wrote the letter to Brian Deer:

My understanding is that…you were approached by GMC case officer Tim Cox-Brown, who asked you to supply the GMC with further information regarding this matter.

I told her that that letter was from a year later. In contrast, the letter Deer wrote in his email to Cox-Brown at the time said:

I write to ask your permission…

“Oh, those words don’t make him the complainant!” – Dr. Godlee said. Yet she insisted that a ridiculously transparent letter sent by the GMC to Brian Deer to cover his tracks more than a year after the fact, absolved him.

“Oh really? Even the judge who sided with Deer – Justice Eady – said he was the complainant!”

She had nothing to say to that.

I also said Deer was already conflicted when he entered the story.

She denied he was.

I said he was still conflicted because of his ties to the pharma front group, MedicoLegal Investigations and the associations of the editor who put him on the story, Paul Nuki, whose father sat on a sub-committee that approved the first MMR vaccine the UK, later banned for causing meningitis. The manufacturers of these vaccines were indemnified from liability by the UK government.

I further alleged that because Deer was the complainant, he shouldn’t have continued to cover the story for a mainstream media publication such as The Sunday Times, as he was essentially reporting on the story he created.

“I disagree with that,” she replied, without telling me why.

As I was trying to inform her of the latest discovery of fraud that Brian Deer committed  – altering content of an article he had originally written for The Sunday Times on his own website - I noticed she was flanked by Drs. Roger Glass and Bruce Gellin. Glaring at my GW Public Health t-shirt, Dr. Gellin cut me off to ask, and not in a friendly manner:

“So what is good for public health?”

I responded it would be a vaccine adequately tested for safety. Otherwise it would just become a new public health threat in place of the disease it was supposed to prevent.

Dr. Gellin answered:

“And in this case, the science is conclusive!”

To which I then put Fiona Godlee on the spot, “No, no, no – her colleague Tom Jefferson said the safety data for the MMR vaccine is largely inadequate.”

Dr. Godlee gave a nervous smile but didn’t say anything.

I told her about Ben Goldacre and how he said the Lancet paper was a good case series.

Dr. Godlee replied, “He used to say that. If you asked him now, he would agree with Brian Deer.”

Perhaps, but I told her that it was only after Brian Deer wrote a blog that was critical of Goldacre’s pro-Lancet stance in the Guardian, Goldacre’s turf, that Goldacre then showed up in the comments section to flatter Deer. 

“Oh, well, that’s just Ad Hominem,” she dismissed.

Yet only two months prior to that, Goldacre told irishhealth.com that Wakefield’s case series was “a perfectly legitimate thing to publish.”

As our discussion was winding down, she invited me to write letters to the BMJ’s rapid response column. I then told her that I had already submitted a letter to the BMJ about Ben Goldacre's About-Face on the issue of Wakefield.

Asking eagerly: “Did we publish it?”

“Yes,” I answered.

“Oh, very good,” she replied, as if that somehow vindicated her for not publishing a number of John Stone’s letters. But I decided to humor her:

“100% publication rate so far,” I said jokingly.

“In the BMJ?”

“Yep,” of course, I had only submitted one letter to BMJ.

I said goodbye to her at that point – leaving the room with the thought that we wouldn’t run into each other again.

However, as I was getting on the elevator, I noticed Drs. Glass, Gellin and Godlee all walking down the hall – presumably to also get on the elevator. Not wanting to be rude, I quickly held the door open for them, which on the flip side, could be misinterpreted as cornering her for further debate. They eventually got on, but were in no rush.

I told Dr. Godlee, “Thanks again for promising to post a clarification; John Stone will be pleased.”

“It’s not a problem,” she replied.

As we stepped out, I told her again about how Brian Deer altered the original version of an article he had written, to erase any mention of vaccine injury – and then lied in the later article he wrote about DTP vaccine injury that she cited in her lecture – claiming that he never followed the story before.

She replied, “Well, if the original article is available online, why does it matter?

“Because Brian Deer is representing on his website an article that was altered from how it originally ran in The Sunday Times!” Furthermore, I made clear to her that the original article is not publicly available online – only through limited access with the intelligence engine, Factiva.

She dismissed my answer, “Oh, that’s just Ad Hom!”

“But you referenced Deer’s earlier article on DTP in the lecture, which formed the basis for how he would approach the MMR controversy.”

I couldn’t make out what she said next – it was a barely audible, tired-sounding response that trailed off.

So I said, “I hope I haven’t been wearing you down.”

Her confused response was, “Oh no, I haven’t been wearing you down…”

Clearly, she was too worn down to use the right pronouns. 

She almost sounded disillusioned, as if she was somehow feeling forced to confront the fact that her journal made an enormous blunder. Nonetheless, I was glad that she still spent a considerable amount of time talking to me – even though she really had no good answers to anything I said, other than admitting that her journal had still not completely disclosed its pharmaceutical ties.

Before parting ways with Drs. Godlee, Glass, and Gellin as they were about to enter the NIH cafeteria, I shook her hand once more and thanked her for talking to me. Roger Glass waved goodbye, but Bruce Gellin walked right past me without batting an eye.

Jake Crosby has Asperger Syndrome and is a contributing editor to Age of Autism. He is a 2011 graduate of Brandeis University with a BA in both History and Health: Science, Society and Policy. He currently attends The George Washington University School of Public Health and Health Services where he is studying for an MPH in epidemiology.

Comments

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"She probably sked for your dept head so she could go back and have pressure put on them about you."

Nope, that was Glass, and he could just as easily find that out by going online and seeing for himself. Nonetheless, what you suggest was my initial conern, but for all I know that has already been happening. It's better to just be open about your affiliations, about which I have been questioned before when I went to speak with Seth Mnookin in New York City by someone who I assume was part of his posse.

To quote the judge my alma mater was named after, "Sunlight is the best disinfectant," and I really believe that to be the case here. As far as I'm concerned, if you shy away from questioning, these people have already won. You have to have confidence in who you are and in your background to take on issues such as this, otherwise you'll get nowhere.

She probably sked for your dept head so she could go back and have pressure put on them about you.

Holy Crap! I wish I could have been your date at that event. I wouldn't have missed that for the world, well I do have to rehabilitate my son from his vaccine injury but if I could have arranged it I would have loved to be there. You are an excellent writer and activist!

Bruce Gellin scares the crap out of me personally! He wants to bring about mandated vaccines for everyone and a pulling of waivers. I've been writing about him and hoping to out his agenda.

Here: http://www.autismrawdata.net/1/post/2011/08/bruce-gellin-md-mph.html#comments

Just keep what you're doing! I rarely check into AOA and wish there was away to tag your articles because they can't be missed.

You take care.

She should also retract the extended insult Deer wrote for BMJ Blogs titled "Piltdown Medicine" along with the smearditorial she cosigned with editors Smith and Marcovitch, who should resign with her.

There are just three things that Godlee should do: retract all Deer's articles, apologise, and resign.

Liz Wager
Publications Consultant - Sideview

Liz worked as an Editor at Blackwell Scientific before joining the pharmaceutical industry, most recently working as Head of International Medical Publications at GlaxoSmithKline.

She now manages her own company, Sideview. Liz chairs COPE (the Committee on Publication Ethics) and is a member of the BMJ’s Ethics Committee and the WHO Scientific Advisory Group on trial registration.

Liz’s publications, presentations and consultancy work have gained her recognition as one of the world's leading experts on medical publishing and she has run courses on six continents.

--------------------------------------------------

I'd imagine that Ms Wager should be more than happy to answer questions in this field in which she is " one of the world's experts on medical publishing'.

As a keynote speaker I'm sure she has faced many challenging questions before.

I think the general public would think those questions fair and reasonable....and so should any member of an editorial board or any organisation who focuses on good governance.

Particularly disability groups and the parents of those Lancet 12 children amongst others.

If you are running an "Improve the Robustness of Academic Research" then surely you must offer transparency ?

You must deal with criticisms of your own protocols.

How would you ever improve if you as a public and professional body do not investigate such areas ?

How could you become such a leader in this debate ... if you shut the gates to questions ?

If the answers to those questions are transparent, objective and reasonable then I see no problem. Reassure us that you are fair and just in the handling of this most controversial issue.

The general public do assume that the medical profession and all those that participate are readily accessible to answer public queries even if some are questions are at the pointy end of'criticism'.

"A university's essential character is that of being a center of free inquiry and criticism - a thing not to be sacrificed for anything else."

Richard Hofstadter

Wager, of course, also lists BMJ as a client

http://www.lizwager.com/

In 2007 I embarrassed her over promoting voluntary protocols for medical ghost writing

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

Reply to Reply to Mark

I suppose there is always some point to going down formal routes but I wonder whether you are aware that the two previous chairs of COPE were none other than Fiona Godlee and Harvey Marcovitch, co-authors of the editorial accusing Andrew Wakefield of fraud, and the present chair a "medical writer" Liz Wager, who works for GSK,

http://www.lizwager.com/

sits on the BMJ ethics committee

http://resources.bmj.com/bmj/about-bmj/advisory-panels/ethics-committee/committee-members

has been a close personal associate of Godlee for at least a decade having co-authored a book with her and Tom Jefferson 'How to survive peer review' in 2002

http://www.amazon.co.uk/How-Survive-Peer-Review-HOW/dp/0727916866/ref=sr_1_1?ie=UTF8&qid=1317650868&sr=8-1

John

Mark

There is a growing concern that the BMJ may have done so to avoid 'academic' scrutiny.

There are several points of concern that should be bought to the attention of COPE Committe of Publication Ethics rather than the disinterested editorial board.

Perhaps an ombudsman could be appointed, I believe this in the BMJ guidelines.

1. Where is the Ethics permission for the author to use medical data of a private and confidential nature to tabulate a 'web extra' feature or for that matter use it in the body of the articles.

http://publicationethics.org/resources/code-conduct

http://resources.bmj.com/bmj/about-bmj/about-bmj/advisory-panels/ethics-committee

2. Under what Code of Conduct is this 'freelance' journalist working under ? Has that journalist held to that Code in both the article and the web site (linked by the BMJ)

What responsibility does the editorial staff take to information that it has linked to via hyperlink within the journal ?

3. How does this article compare to those undertaken by professional science writers - who undertake both University / Academic degrees in both science and journalism ? (see New Scientist as an example of productice , clear and transparent science reporting)

LA Times Code of Conduct example found at this link

http://www.journalism.org/node/125/print


4. How was this article peer reviewed ?

What was the nature and extent of the peer review ?

How many peer reviewers were there ?

What were there qualifications to do so ?

What areas did they cover ?

Who peer reviewed such information as Company documents / Patents / Financial spreadsheets ?

Quite frankly who could do a robust and accurate peer review on the GMC transcripts which are 6 million words of legal 'debate and argument" ?

6 million words is equal to ...well Les Miserables has 513,000 words.

5. There is clear evidence that the accused wrote via email to the editor but was refused Right of Reply seriously undermining the bedrocks of academic debate, transparency and common justice.

There you go.

Jake,

Of course, the title of the paper is 'Ileal-lymphoid-nodular hyperplasia, non-specific colitis and pervasive development disorder in children'.

John

While Gorski has persisted in not actually addressing anything I said, and did not even quote my full question, I notice some of the folks on the "Science"Blogs thread have resorted to semantics arguing that Aspergers is not an "autism spectrum disorder" but a "pervasive developmental disorder," I suppose in a feeble attempt to spare Godlee some embarrassment.

One thing I left out - after she claimed the three Lancet kids weren't diagnosed with AS prior to the Lancet paper but before she claimed AS was not classified as part of the autism spectrum at the time - she claimed Asperger Syndrome wasn't even a diagnosis yet! She totally does not understand the fact that the reason why it was called this in the first place is simply because the physician who discovered it was named "Dr. Hans Asperger." When he did, he did not name it after himself; he called it - entirely independent of Leo Kanner - "autistic." Similarly, PDD-NOS is also known as atypical autism; in fact, that's how Brent Taylor referred to it in his 1999 paper claiming no correlation between autism and the MMR vaccine, citing the ICD-10!
http://www.iaomt.org/testfoundation/nolinkmmr.htm

If Wakefield is guilty of fraud for using PDD and ASD interchangeably - as is typically done in clinical practice - then the whole medical profession is guilty of fraud.

Mark

I recall the remarkable statement of senior Guardian science correspondent Sarah Boseley when the GMC brought in its "findings on facts" hinting that despite the almost universal silence in the mainstream media not all was what it seemed:

“Opinion is divided in the medical establishment on the wisdom of pursuing Wakefield – and particularly his colleagues who played a lesser role in the drama – at the GMC. Some say there was a clear case to answer and that the GMC had no other option but others believe that no good can come of it.”

http://www.bmj.com/cgi/eletters/335/7618/480

This is, of course, a disgraceful testament to how proper public discussion has been suppressed and how the Guardian itself (among others) have been party to the censorship, and continues disgustingly to be so many months later. But it is also very curious that Godlee should have taken the decision to dig herself and BMJ in deeper. Also, of course, she failed to acknowledge the fact at Bathesda presentation that she was just re-cycling old Sunday Times material, unleashed when James Murdoch was appointed to the board of GSK. And she failed to acknowledge it with the BMJ publication itself (which is also an ethical problem).

This does not look very sensible.

John

Mark Struthers

No, Godlee can't bluff her way forever.

Glax

Wondering Why

There's no doubt contacts have been made with police, and there will be more, but getting them to act is something else. We also live in a world where Poul Thorsen has been charged on several counts of financial fraud but the science is still supposed to be beyond reproach. Get the Feds to do anything about that!

Thank you, Jake! The evidence is in … and very, very, very clear. Godlee has comprehensively trashed the reputation of the medical profession at home and abroad … and has left herself no other option but to resign, resign, resign …. in my humble opinion.

Why hasn't someone taken the point by point fraud to the police yet and made them prove they are right? These people are the keepers of public health and should be held accountable for negligence to detail and promoting fraudulant papers. The medical community can't do it. Multiple police reports need to be filed. Jake,,, you did a good job... I just now watched it. Well done.

Three times, the editor made feeble excuse for failing to declare BMJ ties to industry. Godlee made serious error when she published Deer's three scurrilous articles against Andrew Wakefield and then failed to disclose those ties, again and again and again. Jake Crosby wrote three articles exposing Deer’s predilection for fraudulent behaviour... and Dan Olmsted's 'Elaborate Fraud' series, has provided compelling evidence of Deer's outrageous deceptions, perpetrated in true Murdoch style. Fiona Godlee, editor-in-chief at the BMJ, has three times betrayed her stupidity. Dr Fiona Godlee has stupidly left herself no option … but to retract, retract, and retract.

"Well, we don't post disrespectful letters", said the editor when directly challenged by Jake Crosby about BMJ censorship. As a regular 'rapid response' contributor to the BMJ, I have been looking through some comments that failed to achieve a posting on bmj.com. Below is one posted on 17 April 2010 to this 'feature article' by Brian Deer,

http://www.bmj.com/content/340/bmj.c1127.full

Repeated polite requests to post my comments - direct to the editor - were completely ignored.

-----------------------------------------------------------------
"New syndromes and the BMJ"
-----------------------------------------------------------------

I think it is truly shocking that Brian Deer, a freelance journalist, should have been given licence by the BMJ to write an 'Autism Research’ feature article on the pathology of inflammatory bowel disease and to further attack the reputation of Andrew Wakefield, a highly qualified surgeon, pathologist and experienced medical research scientist.

I heartily agree with Andrew Wakefield when he writes in response to this article,

..."it is extraordinary that a journal like the BMJ should have reduced itself to this sort of tabloid medicine from an entirely unqualified and biased source. The egregious errors in Deer's report should cause embarrassment to the BMJ's editors. In a relentless and misguided effort to distract attention from vaccine safety issues, agenda-driven journalism has once again made a mockery of medicine." [1]

[1] Age of Autism. Brian Deer in BMJ and Dr. Andrew Wakefield's Response, April 17, 2010.
http://www.ageofautism.com/2010/04/brian-deer-in-bmj-and-dr-andrew-wakefields-response.html

Competing interests: None declared


Orac is just another pharma bully representing big pharma interest.

Also you notice in Gorski's whingeing rant Jake was "disrupting" the question and answer session with the Lancet editor.

Actually, Jake was the only person posing question's about the research methodology. Gorski seems to be suffering from persecution mania.

So much crazy stuff in Fiona's presentation, like saying that all these kids with IBD & autism were "too good to be true". She comes accross as this nice soft spoken British mum, but says that the media should censor vaccine concerns, and is totally oblivious to what the affected families have experienced. Thank you, Jake, for being a lone voice of reason amidst this propaganda.

Thank you Barry.It is like the accidental slip of the tongue,calling him "Brian" like a good,close friend...Very telling,I have to agree with you Barry.

Orac

"AoA's resident attack poodle Jake Crosby decided to disrupt the Q&A session of a public talk (videocast here) by the editor-in-chief of The Lancet, Fiona Godlee:"


The Lancet ? Oooooops.

kathy Blanco wrote: ".. This means, my son should have NEVER been vaccinated, nor my subsequent children. IT is time to have a prescreen in children, instead of treating them like cattle..."

********************

I agree that we need to stop treating our children like cattle, but I don't think genetic screening is the answer. How can ever we be sure that we're screening for every possible genetic susceptibility, or that the screening tests themselves are 100 % accurate?

The best way to protect children from vaccines injury is never to vaccinate them at all. My sons life was forever changed by his MMR injury, and if I knew at the time that I was choosing between this outcome and the possibility of him contracting measles, mumps or rubella .... I would have given his doctor whole other option on where else to stick that needle.

Our vaccine paradigm is all wrong. If vaccines are hurting one segment of the population, then we can be sure that they’re hurting others too. Autism is just one form of vaccine damage, there are many others that simply don't appear to be as debilitating. People have come to view asthma, food allergies, and autoimmune disorders like diabetes and arthritis as normal. But they are far from normal, they have not always been around, and they are ALL disorders which stem from a malfunctioning immune system. This is a very recent development, and although many causes are being proposed... nothing fits the bill as well as vaccines. These "medications" are designed to tamper with your immune system , and in recent years they've they have unleashed on virtually every segment of the population. And if we think about it, they've been unleashed by the very organizations who profit from the disorders they create.

Vaccines are not a medical miracle.. they are poisonous concoctions that have been misrepresented by a pharma owned media. Neither of my chidren have been vaccinated since 2005, and if I had all to do over, neither would have received a vaccine of any kind. And I guarantee that they'd both still be here, and they’d be a lot healthier than they are right now.

How Gorski and his cronies demean the name of science: all they can do is rant and rage and abuse - not only is Jake a master of his brief he is also superbly mannered - and all these people can do is be crude, rude, raucous, unpleasant. They represent the failure of argument. This stuff will just bounce of Jake: if this is what they do you know you have won.

How you can sit through such 'lectures', and then have to speak to those people afterwards, I will never understand. But I am so glad you do, for all of us. Thank you!

Three times Godlee betrayed her stupidity ... with “three feeble excuses” for conflict of interest non-disclosure.

“And the third which I didn’t say at the time because I was afraid it would make me look stupid is I didn’t know that MMR was made by GSK or Merck; I just didn’t happen to know that.”

"Well, she certainly looks “stupid” now!"

And at times like this, the phrase "the stupid it burns" ... or some such variant thereof ... comes to mind. Or it certainly does to Orac,

http://scienceblogs.com/insolence/about.php

Orac, also known as David Gorski MD, the 'insolent-worldwide-wanker-of-woo' (i-WWW) ...

http://www.ageofautism.com/2008/05/david-gorski-md.html

... normally responds with such respectful phraseology ... to obvious quackery, pseudoscience, poor critical thinking ... or just when general plain stupidity has reached a certain high level.

To Jake, Your ability to follow the intricacies of this case is just amazing. Thanks for keeping at this.And while you're at it, sometime take a little time to fill us in on Dr. Gellin. I personally would really really like to know who are the authors of the autism epidemic and who, for example are the people who ensured that mercury continued to be injected into tiny babies through flu vaccines after "they" "took out all the mercury", which was after the AAP told us that their goal was to stop all mercury going into children. I believe that we owe it to posterity and to those whose brains have been damaged by vaccine components to create a monument and a museum to remind doctors of the future that they too have a choice- As in- Do you want the white marble wall with Dr. Wakefield and Dr. Boyd Haley who chose the path of scientific truth or do you want black wall with the pitiful human beings who preferred to let little children be injected with mercury and other toxic components?( Yeah- tell the architect we dont want the shiny black granite- a sort of cheap dull black is what we prefer)
To Jenny Allan- When I visit the United States I go to California and this is a state that has made mercury in vaccines a crime, starting from 2006, with the exception of a couple of pandemic years in which they allow mercury in flu shots. I have taught nursery and kindergarten age kids for 40 years, and believe me, when you go to California now, you will have a hard time finding a child born after 2006 who is severely autistic. You just walk through the malls and parks and you see the kids with great coordination and expressive faces and terrific language. I ask anyone to show me a child vaccinated in California, who has NOT received any mercury vaccines and has not had any other major source of mercury who has moderate to severe autism.
Alas, I wish I could say the same thing about the asthma, juvenile diabetes and some of the other vaccine effects.
Kathy Blanco- Thanks for posting that. I was trying to tell my daughter, who is a doctor, how some families seem to be reporting reactions to just about any vaccine- It appears to me that the doctors dont understand that at all. They are genuinely baffled .

Jake, Orac has written a post concerning this. Many of his commenters have made some pretty libelous comments that are clearly threatening to you and are obviously intended to harm your reputation.

A friend of mine has even written a blog about it with some of the choicier comments listed, in case Orac (the coward that he is) chickens out and removes his article.

http://my-socrates-note.blogspot.com/

Jenny, how perceptive you are! I was in the study by Warren, my husband and I and my son with autism. I have another daughter with autism as well....anyways, the results were, both my husband and I have a null allele on C4B, which means, when combined, my children have the complete allele, or in other words, non functioning gene on C4B...so bad it was, is the measurement of C4B was absolutely ZERO in ryan. I had to call to make sure that was so. This means, my son should have NEVER been vaccinated, nor my subsequent children. IT is time to have a prescreen in children, instead of treating them like cattle. On top of this screen, a hyper IgE on cord blood would indicate a child already inflammated and hyper sensitive to ingredients in vaccine. (see www.voicesofsafety.com ) and see what I did when I called ACIP members that this is a viable cheap screen to identify which child would not fare well with vaccines. They wanted nothing to do with it! They were rude and completely unworkable. This is the amount of concern they have for our children folks! I mean, they rule out PKU in children, and even give them a dietal food allowance with insurance coverage for crying out loud!? Why do our kids have to be the fall guys for their grand experiment, so sick of it!

oneVoice wrote: "... I think that Dr. Wakefield got to close to the truth and they have dealt with him very aggressively.They have found mr.deer to do the dirty jobs for them....".

************************


I think you are exactly correct, except I think going forward, we should all refer to Mr. Deer as "Brian". At least, that's how "Fiona" refers to him.

Telling a lie is easy, but keeping it going is incredibly hard work... especially when someone with a sharper mind than yours points out the inconsistencies in your story.

"Fiona" was clearly pushed out of her comfort zone by this exchange, and that lack of comfort clearly knocked her off her script. There is no reason that she should EVER be referring to Mr Deer as "Brian", and the fact that she did is very, very telling

Orac (aka insolent-worldwide-wanker-of-woo) is not an important person. Sat on top of one of the twin pillars of the medical establishment, Dr Fiona Godlee is important, at least in Britain. The Chancellor of the Exchequer is important too (equivalent to the US Secretary of the Treasury). George Osborne occupies one of the three most important offices of state after the Prime Minister. In fact, George Osborne is David Cameron's right hand man, as this recent 'Wankergate' tape luridly reveals,

http://www.youtube.com/watch?v=8xjyF0HG5es

What of the quality of leadership, medical, political and financial? I worry about the state we're in?

JAKE - Thank You! Wonderful stuff - I know that you made a difference
Anna
www.arnica.org.uk

Godlee is so evidently an embarrassment and you further embarrassed her. Well done, Jake! As a British, GMC registered doctor, I was very depressed to see such embarrassing behaviour, performed by a leader of the profession, on an international stage.

Interesting when someone asked why certain concerns seem bigger in some places than in other, such as more concern about the MMR in England than in the U.S. The response was that this was an interesting anthropological question, like it was just a matter of applying sociology to better understand rumor mongering. No mention that England was using a brand of MMR that contained the Urabe mumps strain which was known to cause more adverse reactions. They're so proud of their Science, yet they don't apply science to figuring out vaccine injury. Vaccine injury is simply a PR and social problem.

You rock, Jake!!

Thank you for an awesome article!!!!!

Reply to Concerned Part II pointed out the neuroinflammation found by researchers at Johns Hopkins Medical that was present in the brains and CSF.

"the presence of microscopic and immunological findings showing neuroimmune reactions in all of our autistic patients and the cytokine findings in the cerebrospinal fluid (CSF) support a potential role for neuroglia and neuroinflammation in the CNS effects in a number of individuals with autism."

"Our study has also demonstrated the presence of unique profiles of cytokine expression in the brain and CSF of subjects with autism. Two pro-inflammatory chemokines, MCP-1 and TARC, and an anti-inflammatory and modulatory cytokine, TGF-ß1, were consistently elevated in the brain regions studied.

"Cerebrospinal fluid (CSF) studies also confirmed a prominent inflammatory cytokine profile in patients with autism. The presence of a marked increase of MCP-1 in CSF supports the hypothesis that pro-inflammatory pathways are activated in the brain of autistic patients."

The following is an internet comment made by me in response to the JHU Gazette report below. Needless to say it was NOT accepted!!

http://gazette.jhu.edu/2011/07/05/johns-hopkins-researchers-
"How interesting!! A genetic predisposition to autism was also postulated in this extract from a scientific paper, published more than 13 years ago:-

"A genetic predisposition to autistic spectrum disorders is suggested by over-representation in boys and a greater concordance rate in monozygotic than in dizygotic twins. In the context of susceptibility to infection, a genetic association with autism, linked to a null allele of the complement C4B gene located in the III region of the major-histocombatibility complex, has been recorded by Warren and colleagues. C4B-gene products are crucial for the activation of the complement pathway and protection against infection; individuals inheriting one or two C4B null alleles may not handle certain viruses appropriately, possibly including attenuated strains."

This paper, in addition to the papers by Warren et al 1991 and 1996, also referenced a paper by Rutter et al (no date given).

What was this paper?? It was titled:-
'Ileal-lymphoid-nodular hyperplasia, non specific colitis, and pervasive developmental disorder in children.' The Lancet 1998
A J Wakefield, S H Murch, J A Walker-Smith et al (another 9 co-authors)

On Tuesday 19th April, the Johns Hopkins University hosted a talk by Brian Deer who has devoted the past 13 years to destroying Dr Wakefield and his colleagues at the Royal Free Hospital, London, (now University College London). A complaint by Deer led to a three year GMC 'show trial' after which Dr Wakefield and Professor Walker Smith were struck off, although Professor Murch was cleared of all charges. Prof Walker Smith is appealing this decision in the High Court. Sir Michael Rutter was a principal expert witness for the 'prosecution' on disclosure, although he failed to mention he had himself been a well paid expert witness for defending vaccine manufacturers in the US. Not content with this, Brian Deer now claims the entire paper was fraudulent via a specially commissioned article in the BMJ, 'How the case against the MMR vaccine was fixed', (5-01-11).

The 1998 Lancet paper clearly states "We did not prove an association between measles, mumps and rubella vaccine.' The concluding sentence states 'Further investigations are needed to examine this syndrome and its possible relation to this vaccine.'

Am I missing something here?... or have the scientists failed to follow up an opportunity to screen out children with a possible genetic predisposition to autism? These children could have been immunised with monovalent vaccines instead of MMR. Instead, countless millions of dollars were spent on useless epidemiological studies to prove that autism levels were NOT rising. Well THEY ARE and the numbers have reached epidemic levels! Can we please do something NOW, before an entire working age population are instead damaged and dependent."

So I said, “I hope I haven’t been wearing you down.”

Her confused response was, “Oh no, I haven’t been wearing you down…”

*****

Echolalia?

“And the third which I didn’t say at the time because I was afraid it would make me look stupid is I didn’t know that MMR was made by GSK or Merck; I just didn’t happen to know that.”

Well, she certainly looks “stupid” now! How could the BMJ editor-in-chief who had defended the MMR vaccine for at least seven years not have known who made it?


!!!!!

Reply to Concerned

You may also be interested in these two latest studies ...

California Twins Study 2011 Research

Genetic Heritability and Shared Environmental Factors Among Twin Pairs With Autism.

Susceptibility to ASD has moderate genetic heritability and a substantial shared twin environmental component.

To provide rigorous quantitative estimates of genetic heritability of autism and the effects of shared environment.

A large proportion of the variance in liability can be explained by shared environmental factors (55%; 95% CI, 9%-81% for autism and 58%; 95% CI, 30%-80% for ASD) in addition to moderate genetic heritability (37%; 95% CI, 8%-84% for autism and 38%; 95% CI, 14%-67% for ASD)."

-----------------------------------------

This of course is the most robust and thorough investigation on this topic to date.

----------------------------------------

University of California : Davis 2011

Various Media sources but reported at Asia Pacific Autism Conference

"Researchers have for the first time identified two biologically different strains of autism in a breakthrough being compared with the discovery of different forms of cancer in the 1960s..."

Researchers from the University of California Davis's MIND Institute in Sacramento began the Autism Phenome Project in 2006. They have been studying the brain growth, environmental exposure and genetic make-up of 350 children aged between two and 3.5 years, and have so far found two biologically distinct subtypes of autistic brain development.

One group of children -- all boys -- had enlarged brains and most had regressed into autism after 18 months of age; another group appeared to have immune systems that were not functioning properly.

He says in biological terms there are different types of autism, but they all have similar symptoms.

"That's one of the mysteries at this point. We know that there are different biologies but that the behavioural symptoms of children with autism all look basically the same," he said.

"Many, many people now are trying to figure out whether all of these various biological causes are focusing on one final common pathway."

Professor Bruce Tonge, an autism expert from Monash University’s School of Psychology and Psychiatry, said Dr Amaral’s work built on previous research in the field.

“These are important findings but not unexpected. We have known for many years that the number of conditions associated with autism are not one disorder. There’s likely to be different types, groups and causes,” he said.

“He has been able to subtype the two different groups: one have overgrowth in their brains and the other group perhaps have abnormalities in their immune systems which may relate to factors inherited from their mothers.” (Don't mention the dreaded "V" word.)

“This now generates hypotheses we now need to follow up. Why do these children have abnormalities in their immune system?

It may not be the cause [of autism], it may be the consequence of a cause,” said Professor Tonge, who added that Dr Amaral’s work showed how crucial it is to collect detailed biomedical data on children with autism over a long period of time."

-----------------------------------------------

There are I believe very wide implications for the research to come and for the research that has taken place. I particularly note that the evidence of immune system dysfunction found in the gastroenterology of the Lancet 12 and other autistic children thoroughly examined by John Walker-Smith etc showing Microscopic Colitis.

----------------------------------------------------

Lancet - 1998

First, this mucosal abnormality has been apparent in 47/50 children within the autistic spectrum, whether or not there is any perceived link with immunisation. Thus the lymphoid hyperplasia/ microscopic colitis changes were found in over 90% of the autistic children studied.

Walker-Smith et al.

-------------------------------------------------

I also point out the neuroinflammation found by researchers at Johns Hopkins Medical that was present in the brains and CSF.

"the presence of microscopic and immunological findings showing neuroimmune reactions in all of our autistic patients and the cytokine findings in the cerebrospinal fluid (CSF) support a potential role for neuroglia and neuroinflammation in the CNS effects in a number of individuals with autism."

"Our study has also demonstrated the presence of unique profiles of cytokine expression in the brain and CSF of subjects with autism. Two pro-inflammatory chemokines, MCP-1 and TARC, and an anti-inflammatory and modulatory cytokine, TGF-ß1, were consistently elevated in the brain regions studied.

"Cerebrospinal fluid (CSF) studies also confirmed a prominent inflammatory cytokine profile in patients with autism. The presence of a marked increase of MCP-1 in CSF supports the hypothesis that pro-inflammatory pathways are activated in the brain of autistic patients."

------------------------------------------------------

concerned

"So, keep up the arguments, the exposure and the discussion. Even though we do no all agree lets keep it on the table and discuss some more data."

We don't all agree and that's a very healthy attitude to have because there are lots of differing viewpoints on this matter.

I also agree that dissemination of key data is also a very good ideal and enables each and everyone of us to get a clearer picture of what is going on.

------------------------------------------------------

For instance did you know that in the GMC trial in reference to Lumbar Punctures a simple and very safe procedure in skilled hands , just as colonoscopy is, the following evidence was presented by -

Dr Neil Howard Thomas

Bachelor of Medicine and Bachelor of Surgery from the University of Cambridge in 1982

Royal College of Physicians in 1987, and Fellowship in 1999

Royal College of Paediatrics and Child Health in 1997
Consultant paediatric neurologist at Southampton University Hospitals NHS Trust held that post since 1993

"My primary contract is an NHS contract, so my primary role is one of clinical practice, but I teach, because the hospital is the primary teaching hospital for the University of Southampton."

Q"Can you, as a paediatric neurologist, the only one from whom the Panel has or will hear, understand why Professor Walker-Smith’s team would be interested in exploring whether or not there was an underlying metabolic disorder in these children?
A The neurological conditions with which these children presented were very serious and they had a major impact on the child’s life, the family’s life and the question as to what was causing that was obviously of paramount importance. I think that therefore it is entirely reasonable to try to investigate that and to gain an answer to the question: what was the underlying cause of that disorder? "

Dr Thomas further

"I was referred somebody three weeks ago who was a child with long-standing autism whose behaviour had changed significantly. While that is recognised as a feature of autism given the circumstances I considered it appropriate to investigate the child further. He is going to have an MRI scan and he will have lumbar puncture and a general anaesthetic when he has his scan because of the nature of the change in his behaviour has been so abrupt."

Further Dr Thomas considered each child that had a LP undertaken as being right and proper as a clinical investigation.

Child 1 - No Lumbar *

Child 2 - Lumbar performed "Both prosecution and defense agreed when admitted, had signs and symptoms of an organic metabolic disorder, no one disputes that lumbar puncture was appropriate in this child's case."

Child 3 - "but it would still be my view that lumbar puncture would be an appropriate investigation, given the history" Paeditaric Neurologist Thomas and further " ...but if I consider this patient on his own, without any other features, if he presented in my clinic, I would consider doing a lumbar puncture on him."

Child 4 - No Lumbar *

Child 5 - No Lumbar *

Child 6 - No Lumbar *

Child 7 - No Lumbar *

Child 8 - No Lumbar *

Child 9 - Lumbar - Child 9 was given a Lumbar Puncture by a Paediatric neurologist at Chelsea and Westminster.
Obviously based on clinical investigation and need.

Thomas - "The question of why this child had the problem still remained. He had had a number of investigations in the past, and I think it was appropriate to address that by examination of the cerebrospinal fluid."

Child 10 - . "I think that it is a clinical view that further investigation would be indicated and that that investigation might include a lumbar puncture, an examination of spinal fluid."

Child 11 - No Lumbar

Child 12 - Lumbar - "I cannot comment on that in relation to this child, because the records are not clear enough. As a sort of decision, if you are asking me whether I think it is a reasonable investigation to do in the overall assessment of this child, then my answer would be yes; but I cannot answer for the individuals involved at the time. It is not clear to me exactly why those things happened in that order."

Child 12's records are incomplete referral from the United States.

----------------------------------------------------

One then finds it difficult to reconcile that the GMC weighed the evidence of a Psychiatrist over a Paediatric Neurologist.

If this was indeed research then it logically follows that each and everyone of those children would have had a Lumbar Puncture.

The same of course applies to the colonoscopies which were performed by three of the leading gastroenterologists in the UK . One of the John Walker-Smith has been described as ...

"From that time until the present, John has established himself as one of the premier, if not the premier, pediatric gastroenterologist in the world with a personal Chair in Pediatric Gastroenterology at St. Bartholomew's and, since 1995, at the Royal Free Hospital. His abilities as a clinician, clinical investigator, and educator through lectures, review articles, and textbooks have resulted in a worldwide following by former fellows, colleagues, and general pediatricians. Having been with John at meetings on numerous occasions around the world, I never cease to wonder at former fellows in the host country of the meeting wishing to spend time with their former mentor. John, you have contributed a great deal to the development and continued excellence of our field. We owe you a sincere debt of gratitude. We wish you well in your adventure as the Society of Apothecaries Lecturer in History of Medicine. Maybe we can convince you to write the definitive history of pediatric gastroenterology as a future assignment. With deep respect- "

-------------------------------------------------------

When the GMC makes such a pronouncement of guilt against such an eminent man .... without the supporting evidence from either parents or patients.

If the case against John Walker-Smith cannot be sustained then what does that mean for the case against Andrew Wakefield. You cannot separate the two.

I say simply "The GMC cannot be believed."

Hey Jake,

That was a great fieldtrip that you went on! Your defense of Dr. Wakefield and John Stone was well done and accurate.

Your brilliant memory and clarity on the facts are stupendous and your "rotten head" exchanges are priceless.

Thank you!

Open Letter

Dear Ms Godlee and Smith and Mr Marcovitch

Please issue a correction notice for paragraph

"Any effect of the scare on the incidence of mumps remains in question. In epidemics in the UK, the US, and the Netherlands, peak prevalence was in 18-24 year olds, of whom 70-88% had been immunised with at least one dose of the MMR vaccine.21 22 Any consequence of a fall in uptake after 1998 may not become apparent until the cohorts of children affected reach adolescence. One clue comes from an outbreak in a school in Essen, Germany, attended by children whose parents were opposed to vaccinations. Of the 71 children infected with mumps, 68 had not been immunised.23"

and referenced as

23 Roggendorf H, Mankertz A, Kundt R, Roggendorf M. Spotlight on measles 2010: measles outbreak in a mainly unvaccinated community in Essen, Germany, March-June 2010. Euro Surveill2010;15:2

This error was the subject of a Rapid Response by Kim Britton (Published 4 February 2011.

There is no correction notice issued.

This type of factual error may inadvertently mislead the casual reader

Thanking you for your time and energy in this matter.

regards

These people like to think of themselves as nice people and patronize the little people as misinformed on a diet of junk science.
Many thanks to Jake and all the best with your studies. Many thanks also to John Stone for your perseverance, clarity and guidance.

It wasn't just Godlee that signed off on that now infamous editorial ...

1. Fiona Godlee, editor in chief,
2. Jane Smith, deputy editor,
3. Harvey Marcovitch, associate editor

Three senior BMJ editors who would have contributed and cross checked facts and references. Perhaps ?

In one part Godlee et al state ...

"Any effect of the scare on the incidence of mumps remains in question. In epidemics in the UK, the US, and the Netherlands, peak prevalence was in 18-24 year olds, of whom 70-88% had been immunised with at least one dose of the MMR vaccine.21 22 Any consequence of a fall in uptake after 1998 may not become apparent until the cohorts of children affected reach adolescence. One clue comes from an outbreak in a school in Essen, Germany, attended by children whose parents were opposed to vaccinations. Of the 71 children infected with mumps, 68 had not been immunised.23"

...and here's where the simple error lies

"One clue comes from an outbreak in a school in Essen, Germany, attended by children whose parents were opposed to vaccinations. Of the 71 children infected with mumps, 68 had not been immunised.23"

Unfortunately as one of the Rapid Response letter writer Kim Britton points out ...

"Please correct the error in the following paragraph, which references a mumps outbreak in Essen Germany. The article cited to support this clearly indicates the outbreak was of measles, not mumps"

Has the article a further correction ... well NO,

Having two corrections would be a bit embarrassing ... but in the interests of factual accuracy must be made when it was pointed out nearly 6 months ago.


Editorial

http://www.bmj.com/content/342/bmj.c7452.full#ref-21

http://www.bmj.com/content/342/bmj.c7452.full/reply#bmj_el_249379


So what they receive from Merck and other Pharma companies:
1.Advertizing Revenue
2.Sponsorship Revenue
3.Unlimited Educational Grants
4.Free meals at meetings.
So,in plain english,they are not going to bite and expose
the dog who feeds them.Super job and responses Jake.I think
that Dr. Wakefield got to close to the truth and they have dealt with him very agressively.They have found mr.deer to
do the dirty jobs for them.The conflict of interest is
crystal clear.Thanks for your hard work Jake.

concerned

Just to point out that the Lancet paper was not, was never intended to be a statistical study: it was small case series study. It never pretended to have statistical significance: it examined data from a group of patients with somewhat similar symptoms who were seen and investigated purely on the basis of need.

details = WOW! Just awesome reporting, Jake. Keep it coming. We need you here.

Unfortunately, fakery and hyperbole are rampant in science, including medical science where patients well-being is at risk. As pointed out most involved in the science process have varying degrees of conflict of interests.

However examining such a small of patients and arguing over these tiny number of patients, it seems that the data can not support many conclusions with sound statistics. If the data was collected in a manner that supports allegations of misconduct, that is all that can be addressed.

Some scientific reports were never intentioned to become fact or hard evidence, but were more modest reports and observation in need of further verification. However due to the media such as a publication in Lancet, science reports sometime have a life of their own, just like a Youtube film gone viral. Perhaps it is not pre-meditated with careful thought about the outcome.

Perhaps the surprise was that Lancet published the article and the MDs are caught in a stream of expectations, a model makes sense, many are in need of a solution to a real problem, etc.

Although I suspect the vaccine cause of Autism syndromes is incorrect, I do believe that the Age of Autism forum has served many very important functions. A couple of these include:

AOA has said there is a complete focus on DNA mutational studies for AS causes in total disregard of environmental effects, this is true.

AOA has called out Dr. Thomas Insel for his buddy-buddy relationship with mega Pharma "Paxil for children in lunch boxes" shill Dr. Nemeroff, even after Dr. Nemeroff was disciplined by Emory. Dr. Insel defeated the disciplining or holding of Dr. Nemeroff to any degree of accountability, for taking money on the sly. Dr. Insel, "We can show the rest of medicine how to clean up our act." The prime time television shows are so enamored with these Dr. Bozos it is embarrassing to watch. The prime time interviewers typically say, "so glad to have you on our show" and display such gosh behavior ask about personalized medicine, a non subject. There are no pointed questions on TV, just a bunch of MD backslapping congratulations thanks Doc.


So, keep up the arguments, the exposure and the discussion. Even though we do no all agree lets keep it on the table and discuss some more data.

I think her comment, "Oh No, I haven't been wearing you down"
was a Freudian slip--meaning you (Jake) won"the wearing down face-off."
Maurine

Jake perhaps Dr Glass asked you who the head of the department was because he wanted to complain about your questioning , i have to say bravo to you for your questioning of Dr Godlee and for your persistence , words are very powerful , these people can not defend themselves against the many thousends of damaged children

Jen

I think some people may think like that but I am more than ever convinced that Godlee is so convinced of her own rectitude that she thinks it doesn't matter if she cuts a corner here or a corner there. She's is so comfortable with the revenues from Merck and GSK that it is hard to persuade her that she ought to declare them (it doesn't really even occur to her). It ought to be pointed out that she is as well a senior officer of BMJ's parent organisation the BMA (although the BMJ is supposed to be politically independent of the BMA).

wondering why

Of course, the police all over the world have a dismaying tendency to show discretion about what they prosecute and what they don't. For instance, presently they are are ethusiastically prosecuting the wife of a Liberal-Democrat MP who allegedly stole a cat from his mistress - and apparently the British tax payer has the money to pay for it (the MP is naturally a multi-millionaire).

http://www.telegraph.co.uk/news/politics/8792130/MPs-wife-stole-kitten-from-mistresss-home.html

Well done Jake!

Elizabeth

Rather important to say that it was three weeks ago and there has been no amendment, or update of the Merck disclosure. The notice still reads:

"The BMJ should have declared competing interests in relation to this editorial by Fiona Godlee and colleagues (BMJ 2011;342:c7452, doi:10.1136/bmj.c7452). The BMJ Group receives advertising and sponsorship revenue from vaccine manufacturers, and specifically from Merck and GSK, which both manufacture MMR vaccines. For further information see the rapid response from Godlee (www.bmj.com/content/342/bmj.d1335.full/reply#bmj_el_251470). The same omission also affected two related Editor’s Choice articles (BMJ 2011;342:d22 and BMJ 2011;342:d378).

http://www.bmj.com/content/342/bmj.d1678.full

Some people have voiced the theory that in loose terms this covers the BMJ Learning/Univadis deal, including by implication Godlee to Jake, but it certainly doesn't seem to fit into the category of either advertising or sponsorship: this looks like a straight business contract for BMJ to deliver mutually agreed services to the pharmaceutical giant (and in 2006 when it was signed late manufacturer of Vioxx). Of course, Merck like GSK do have a sponsorship deal of BMJ's awards so it really isn't clear that this major business contract has been acknowledged.

Why all the difficulty about this over many months if it would just take a few words to spell it out?


Jake, thank God for people like you who can go head to head, detail by detail with these people. Not everyone has the presence of mind and stomach to be able to do it. Those are some slippery people and you made them squirm. Nice! I think Benedetta's right on the money. They want to make a real show of dressing down Dr. Wakefield, with bogus "evidence" against him and scaring any and all other professionals into even discussing adverse events associated with vaccines.

Jake, has anyone ever presented the truth and asked them to prove it wrong? Can't police complaints be made in UK for fraud on their behalf, especially in the light of the Murdoch trials. Has someone gone to THE POLICE?...... and filed a Police report on these people who are spreading disinformation that is disrespectful to sick children as well as potentially causing harm. Call Scotland Yard with the hard truth and ask them to ask Godlee to show evidence you are wrong. Love what you do. Accuse them of the N word... Negligence!

Yes, yes the main idea going around that room was how to stop "faster" anymore docs and researchers from disclosing anymore vaccine damage/injuries.

Dr. Wakefield was such a good communicator that he out foxed all the high up medical officials. What an extrodinary super human man.

Of course it helps to appear to be such a super man when the truth that Dr. Wakefield wrote and spoke was behind him.

The truth not Dr. Wakefield is really what kept "the poor under dog officials" appearing as "flat footed."

Jake, your tobacco science retort brings to mind a line from Pope: "True wit is nature to advantage dressed, / What oft was thought, but ne'er so well expressed."

Keep it up, young man.


Thanks for courageously bringing to light some of the many inconsistencies in this health disaster.

Dr. Gellin's invoking the "good for public health" also stood out for me. I would have been so tempted to retort, "What public health?" If the public was healthy, or at least as "healthy" as I grew up with, I probably wouldn't be spending any time here, and they probably wouldn't have to, despite their best efforts, sometimes face such questions. Thank you for trying to open some eyes.

It would be nice if you could rig up a small "Jake cam" that would digitize these conversations. Great work.


One question to ask would be "Could the Vioxx people be wrong again on the toddler value of their liability free products" ???


They seem so proud of what they have done to Dr. Wakefield's paper, a simple 1998 five page item on 12 children with no formal conclusion... but that more research is needed.

About five years after it is published, they twist 10 doctors to recant a possibility statement that was not even in the paper to begin with.

They then say that the doctors recanted every issue in the paper which was certainly not the fact. A "possibility" that the MMR is harming some susceptible children will always be a possibility, if not simply a proven fact by now.

A hick Murcoch journalist then spends seven more years trying to find something wrong with the five page paper in the name of "BMJ science" who can hardly wait to print each and every word.

Hi Mary,

Cochrane's vaccine division is based in Italy and the MMR review was funded from Italian and European sources, however the central administration is based in Oxford and was being bailed out by the UK Department of Health at the time of publication. You may also find interesting this article by Clifford Miller in Journal of American Physicians and Surgeons:

http://www.jpands.org/vol11no4/millerc.pdf

John

Hmmmmm....

"Pronoun reversal is when the person with autism confuses first and second person pronouns in speech. (Autism and Language: Description and Diagnosis) He will use "you" to refer to him or herself, and use "I" to refer to his or her listener. This might be a sign that children with autism fail to identify themselves as separate from the person with whom they are speaking or might just be experiencing linguistic confusion."

Having told her I write for Age of Autism, she said:

“I think Age of Autism is mostly pseudoscience.”

I replied, “I think your defense of MMR is mostly tobacco science.”

“Oh, okay,” she said in embarrassed laughter, “I haven't heard that one before!”
--
That was one of *the* best exchanges I've read on AofA ever. Thank you, and way to go, Jake!

Thanks Jake for putting her on-the-spot! Someone needs to be held accountable for this mess!

Kevin


"'So what is good for public health?'

I responded it would be a vaccine adequately tested for safety. Otherwise it would just become a new public health threat in place of the disease it was supposed to prevent."

You hit them where they live with this one, Jake. Excellent point! There is no denying that they have become the disease vectors. In order to keep our children safe from harm, parents are learning the hard way that they must also teach their children about doctor-danger.

I too was horrified when I heard Dr. Roger Glass relate his concern for the vaccine, not the children who fell victim to adverse events from the vaccine, in his introduction for Godlee. He exposed the ugly underbelly of vaccinologists that I suspected was hiding beneath a cover of concern for children's health and welfare.

to add, and I hope it's not a stupid question, but, what amount of vaccines did these children have up to that infamaous MMR shot? My feeling at least for my kids is that every vaccine damaged in increments, one setting the stage for the other. Every fever that was induced was followed by tylenol of course, reducing all chances of detox of metals or levels of glutathione. I believe in the very viable theory that by the time the MMR comes around, the damage may have already been done, therefore, if they detect the MV in the gut, it is viable to believe, they can detect the polio virus in the gut, and on and on it goes. I am going to block some tissue in the gut to send to Judy Mikovits of XMRV fame, and I believe that will be the reservoir too for this retrovirus. I also think that the influences in utero, such as mothers immune response to her immune derangements take or set the stage to heightened alert. Such things as lyme, or a virus, or a retrovirus circulating in her system, even simple strep bacteria can set the stage for autism either by the initial attack of those, but also the mothers immune response to those. So why do vaccines act as a tipping point? Because it circumvents all the natural routes of immune function and bypasses things that shouldn't be bypassed, and directly puts viruses into our bloodstream where they don't belong. I think it's time to not only scope our kids for MV persistence, but all the other gang like viruses and retroviruses etc are in that same area. If the vagul nerve is in the gut, and highways all the way to the brain, what part of this science do they not get? Is it not basic? Even a parent like me gets it? What makes them so stupid and blind? I guess in place of real vision, they have dollar signs in their eyes. Or, they are green with envy that they can appear so militarish to their collegues, and have a closed mind about the holy grail of vaccine technology, which is in essence, guessing. The whole thing rots of stink, and makes no sense that you can vaccinate a population without some people going down...even in cattle yards this is so.


After listening to the exchange on the Videocast, I have to wonder why Fiona Godlee is on a first-name basis with "Brian." It doesn't seem very professional or unbiased of her to defend "Brian" as if she's talking about an old friend. She certainly didn't refer to Dr. Wakefield as "Andrew."

Godlee is no better at covering her tracks than Deer is.


Jake, you so impress me, and I hope to one day meet you and shake your hand in behalf of my two vaccine injured children. I have always stated that those that defend vaccines always have a financial or vested interest in defence of them, but i wonder if that was not there, if they would still defend them, after viewing the evidences of their connections. Better yet, a view of a a typical folder an autism parent keeps in defence of their view of the damage done, the irrefutable things like gut and brain inflammation, immune dysfunction, etc would make an average physician go huh? In that light, I offer this thought. We all have to think, why my kid had a problem. I think a predisposition like XMRV is to blame. A pre condition of immune influence or inability to detox metals and deal with viruses in a timely influential manner. In like fashion, the denials of XMRV loom large as well, and those in authority to keep it in the research mind realm, has gone by way of contamination, it's not there, let's move on. Meanwhile, they will fund endless research into how bad of genes we have, and that's why we are here. Until the truth comes unraveling, and until people like you go to these very meetings expressing eloquently and with honesty, what is happening, these "pseudo concern" meetings will endlessly imprison not only our children, but countless generations of children. God help us all.

The Dr. Godlees of the world are used to appearances before the cheering section and don't know how to handle an informed, intelligent critic.

Thanks John, for the update. I haven't pursued - or investigated - all the alliances, publications, funding sources, etc. of Cochrane, but I'm sure the vaccine pushers and their recondite cronies like Cochrane would provide ample fodder for a multi-volume horror-crime-suspense-detective novel. It would be one of the greatest of science fiction works!
Adda boy Jake. Keep studying. I agree with the previous commenter. These are not simply technical issues, but are essentially moral issues with political implications.

Oh my god. That was fantastic, Jake. Deep courage, and an incredibly knowledge of people and timelines. Not many are qualified to do what you just did.

I hope you don't get any "feedback" from your institution about your questions for Dr. Godlee. I think Dr. Glass' asking of the name of your chair at GW was a not-so-veiled threat toward your grad student status. Please advise your readers if you get ANY blowback from your department.

RT Contracting

I don't know what Kim would say but if there is some substantive point to be answered (and it isn't the same thing over and over) we do post. There are of course ways that a site can be targetted as we found on JABS a few years ago after I submitted something unflattering about Ben Goldacre to BMJ, which actually did get to be posted a week later:

http://www.bmj.com/content/335/7618/480/reply

meanwhile a gang of internet trolls had swept over the JABS site - which was not at the time pre-mediated - and involved the regular contributers in endless hours of pointless exchange, and completely unavailing attempts to be polite and reasonable. So, of course, there are limits: it doesn't help if you have people being rude about vaccine damage to parents who have seen their children go down after vaccination.

Nice man, that Goldacre!


At first it was the parents that came to complain, they did not seem to care because it was not that many parents; and it was after all for the greater good!

At last an actually victim stands before them, and tells them point by point their sins.

It seems to me that Jake is Karma, the Hand of God.

I have prayed hard enough to know that God will not change the natural laws he set forth to govern this Earth (what ever happens in adverse reactions to vaccines), but I have also noticed God does not mind a bit to use miracles when it comes to bringing knowlege and thus hopefully changing the hearts and minds of human beings no matter how twisted, messed up and confused they have become.

Knowledge had come, and now it is their choice, and their sin.

Well, Jake, I have to thank you for making the trip out to Maryland, and for having the extraordinary fortitude to ask your question, and follow up with Ms. Godlee afterward. Your command of the facts of the MMR/Wakefield fiasco is so impressive. I am positive that you deeply disturbed many of the people present at this NIH event. You put troubling questions into their heads about both Brian Deer's and Fiona Godlee's motives in writing/publishing the BMJ articles lambasting Dr. Wakefield. That is priceless.

Although I still think you should run for Congress one day and trash the laws protecting vaccine manufacturers, I also think you would make a brilliant attorney. Your opposition wouldn't stand a chance in court. Just a thought. : )

Thank You Jake for all you do to shed light on things.

Thank you for defending Dr. Wakefield. That man is a hero in my book and always will be.

I so admire your dedication and desire to expose all the lies, corruption and cover ups.

This article is really what I needed after reading the NAA article about aversive being used on children in Texas (really around the country) and another article in another location about a little girl with autism taken from her family because she wandered into a neighbor's garden. The government removed her from her home and have held her for over 100 days and are forcing psych meds on her. She is only 8 years old.

And RTContracting...your comment got published I see. So your point is stupid.

It is ironic that Jake criticized the BMJ for not publishing every single one of John Stone's letters.

The BMJ at least published some. Age of Autism almost never publishes critical comments.

Go to the head of the class, Jake. I just love this!
Maurine

Beautiful Jake, just Beautiful!

Mary

It may be that some of your questions are answered in a deadpan way in the Cochrane Review of MMR. The conclusion of the abstract (which must be distinguished from the ultra devious plain language summary) reads in its entirety:

"The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate. The evidence of adverse events following immunisation with MMR cannot be separated from its role in preventing the target diseases."

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004407.pub2/abstract

So, in other words the safety studies are largely inadequate (we don't know whether it is safe or not) but we bang on with policies regardless. A further moment's thought and one might pose the question how you can have so many studies (about 5000 related studies in all) that are too poorly conducted to provide an "adequate" answer, and draw your own conclusion about what institutionally is going on - I draw the scientific conclusion that the industry, governments and the medical profession do not want to find out. In fact the main text of the review ends with the remark (not specific to MMR):

"More attention needs to be paid to the design and reporting of safety outcomes in vaccine studies, both pre and postmarketing."

About Jefferson, I can only share your frustration: why does he not speak out about this like he does so forcefully about flu vaccine: the issues are scarcely different and I can only believe he knows better but is unwilling to accept the professional and political consequences. There's no doubt that he and Godlee have been long term professional friends and of course she has always taken a view about MMR - of course they don't have to share exactly the same opinions but if is he trimming it may not be just to appease her. As to the lead author of the paper Demicheli I recall him being irresponsibly upbeat about the review at the press conference giving the impression that the 31 selected studies were of good quality, which is quite apparently not the case if you read what they say about them, and in most cases it is quite difficult to understand how they met the basic inclusion criteria.

I don't, of course, know exactly how you worded your question to Jefferson, but I guess he is frightened of being quoted. I once had a very pleasant private email exchange with him and of course I have never repeated what he said.

John

What a great read! What a lively series of exchanges -- point after point after point. Jake, you have total command of the topic and an outstanding capacity for debate. Masterful. Bless you for your relentless pursuit of truth and ethical behavior.

I am so proud of you Jake for attending. I appreciate all the points you brought up with Dr Godlee etc and the way you stuck up for John Stone. A brilliant and very clear article.
Many thanks and keep up the good work.
www.followingvaccinations.com

My goodness Jake, what a warrier!! I particularly loved this part of your repartee with Godlee:-

“It's my conflict of interest, not Deer's” - she told me.

“The BMJ commissioned him,” I replied.

“Yes, but it's my responsibility as the editor.”

“The fish rots from the head.”

“Oh, wonderful…” she said in more embarrassed laughter.

“It's a Russian proverb,” I clarified to her."

And how about this from someone 'much' of whose career was spent developing vaccines against rotavirus including a collaboration with Offit:-

"Dr. Glass said he was not interested in vaccine adverse events until the first Rotavirus vaccine was “crippled” by intussusception."

So that's OK then; it was the VACCINE that was crippled, NOT the children. In fact NONE of these self interested individuals has ever expressed the slightest interest in children' adverse vaccine effects. What a load of doublespeak from these pharma sponsored mouthpieces!! Thanks Jake for your wonderful exposure of these persons' lies and/or sheer ignorance!

Go Jake, go!

Awesome job Jake - great clear thinking on your feet. Thank you.

Having told her I write for Age of Autism, she said:

“I think Age of Autism is mostly pseudoscience.”

I replied, “I think your defense of MMR is mostly tobacco science.”

“Oh, okay,” she said in embarrassed laughter, “I haven't heard that one before!”

[snort]
Thanks for the laugh, and all that you do for us!

Oops. Correction to earlier comment: I meant to say thanks for reminding those people that they can't sweep the truth under the rug with their lies.

When people aren't worried about the truth, they tend to be sloppy with facts. Thanks for the report on the lopsided debate, Jake. More importantly, thanks for stepping up and making sure those people understand that their lies can't be swept under the rug.

Jake, is Jefferson a lapdog of Godlee? Interesting. I emailed Cochrane to demand evidence of cited long term vaccine studies demonstrating their safety and effectiveness. Jefferson himself wrote back to me. He claimed my question wasn't clear enough for him to answer. I didn't reply. I assumed any question I posed to him about vaccine studies would be considered unanswerable. Mary Podlesak, BA Statistics, Economics, MS Industrial Engineering SUNYAB

Jake .. you have courage born of intelligent convictions .. which is a very rare, precious commodity .. and .. "Drs Godlee, Glass and Gellin" are not likely to ever forget meeting you.

Thanks for all you do.....

'There's none so blind as will not see.' Great reporting, Jake.

John

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