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Dramatic Development Further Exonerates Andrew Wakefield and Puts Pressure on British Medical Journal

Dr-Fiona-GodleeBy John Stone

In the latest dramatic twist in the Wakefield affair the senior histopathologist co-author of the controversial  Lancet paper, Dr Amar Dhillon, has defended  his contribution to the study. His intervention further knocks on the head allegations from journalist Brian Deer and the editor of the British Medical Journal, Fiona Godlee, that Wakefield had manipulated the data. In a statement to the journal has Dr Dhillon has explained his contribution to the study and set it in the context of regular clinical practice. Hidden from British Medical Journal readers the case against Wakefield has been unravelling since last week when in answer to criticism from microbiologist Dr David Lewis one of the experts hired by BMJ to review the data, Prof Ingvar Bjarnason admitted to Nature.com that “the forms don't clearly support charges that Wakefield deliberately misinterpreted the records. "The data are subjective. It's different to say it's deliberate falsification," he says," he says”. Bjarnason’s admission was particularly telling given his public hostility to Wakefield and his research.

Dr Dhillon notes:

“The reappearance (BMJ Nov 2011 online: http://www.bmj.com/highwire/filestream/536428/field_highwire_adjunct_fil... ) of some of my histology grading sheets for the Lancet 1998 study (Wakefield AJ et al. Ileal lymphoid nodular hyperplasia, non-specific colitis and pervasive developmental disorder in children. Lancet 1998;351:637-41) is interesting. I have not seen the grading sheets since 1997-98 when I gave them to Andy Wakefield. Following the interest shown in the grading sheets in the November 12 2011 BMJ Feature “Pathology reports solve “new bowel disease” riddle” (BMJ 2011;343:bmj.d6823), accompanying articles and editorial it is evident that there are a number of misunderstandings. Many of these are a result of a lack of understanding of the essential difference between the systematic documentation of specific microscopical features in a grading sheet by a “blinded” (ie in the absence of any clinical, or other information) pathologist on the one hand; and on the other hand concluding an overall clinicopathological diagnosis by integration of clinical information with diverse lines of investigation (including information in the grading sheet). The difference between the two activities should be understood better…

He concludes:

“At the time of submission of the Lancet 1998 publication I had the clinical, laboratory, endoscopic and histology information presented to me in summary tabular form, and aggregated descriptive text only.

 -My grading sheets were with Andy Wakefield and my general recollection of my impression of my slide review was that some biopsies were a bit inflamed, and others were not: I did not know which case was represented by which set of slides, and which sets of slides were “normal” controls. As far as I recall, the changes were not severe in any of the slides, but it is not unusual for gut mucosal biopsies to show little abnormality even in clinically well defined cases of gastrointestinal disease, particularly in children

 -My clinical colleagues had collated all of the available information, including my microscopical grading sheet observations in the context of their knowledge of each patient’s condition and concluded a final diagnosis of colitis when this was considered by them to be appropriate

 -Thus, at the time of submission of the Lancet 1998 publication, with the limited supplementary information available to me (which I had been prevented deliberately from knowing during the study); and in the context of a comprehensive clinicopathological review by trusted clinical colleagues, the designated diagnosis of colitis seemed to me to be plausible.”

The statement does not hint at anything resembling research impropriety.

With this in view I have written to Dr Godlee through BMJ Rapid Responses suggesting it is time to call it a day:

‘Dear Dr Godlee,

How can this folly go on? It is now perfectly clear that Andrew Wakefield acted as part of a team and the clinical analysis was conducted with the highest of motives, and expertise.

You have had your answer - please can we now have an apology. It would be appalling if you took any action now but to back down.

Sincerely,

John Stone

Godlee has been calling for a further inquiry into the Wakefield affair – it is almost as if having dug herself a pit, she is calling for someone else to pull her out.

John Stone is UK Editor for Age of Autism.

Comments

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The truth about the harm the vaccines are causing an increasing subset of the population will come out. This is a forty year old mistake which has now escalated due to the increase in the number of doses in the individual shots during the critical stage of brain development.

OK John-I stand corrected!! But yes-there were lots of other children treated for their bowel problems at the Royal Free Hospital under the excellent care of Professor Walker-Smith and his clinical team, including my autistic grandson. Taking part in the research, conducted by Dr Wakefield was optional, but most parents were happy to agree to 'donate' extra biopsy and other samples, taken during diagnostic procedures.

Josh's very harrowing story is told in Silent Witnesses.

Hi Jenny

I don't believe Josh Edwards was one of the 12 from what I know of his history but he was one of the patients in the clinic.

John


Ottschnaut asks:-
"Is the kid in the video, which I have seen, improperly represented in the video, or is Deer caught red handed being his oafish assish self, whining in his high pitched, girlish voice, "That boy doesn't have bowel disease?"

I've met 'the kid'. He is most definitely one of the Lancet 12, and his story is told by his mum in the second volume of 'Silent Witnesses' available online from Slingshot Publications. This young person was actually present,(in his wheelchair), at the GMC demo Deer talks about, and is quite a character. I have huge admiration for both this 'kid' and his mum. It takes guts to tackle the likes of 'Deer' and put up with his snivelling insults. His mum was also interviewed for ITV, after one of these GMC demos in support of Dr Wakefield and his colleagues, but guess what? The interview was PULLED- after less than a day.


The Empress has no clothes … and it’s not a pretty sight at all.

On Gorski's circle jerk blog, Deer writes:

http://scienceblogs.com/insolence/2011/11/brian_deer_strikes_again_more_evidence_o.php#more

"@brian

There was a particularly sickening moment in all this a couple of years back during Wakefield's GMC. Outside the building a gang of his acolytes turned up, including one woman who brought a huge poster of her son, who'd had a big piece of his colon chopped out. He looked awful. He'd appeared in media previously, having been seen at a different hospital, not part of the Wakefield research, and diagosed with a severe food intolerance. But Wakefield's people - being what they are - pretended that he was one of the Lancet children, and that therefore I was a liar when I said that the patients in the study didn't have IBD. The deceitful representation of that boy even appeared again on Olmsted's blog just a few days ago in another billious tirade against me.

So, obviously, it has been important to me that, thanks to the surfacing of the histopathology raw data which the BMJ has now published, I've been wholly vindicated. Again.

Posted by: Brian Deer | November 13, 2011 3:12 AM

Is the kid in the video, which I have seen, improperly represented in the video, or is Deer caught red handed being his oafish assish self, whining in his high pitched, girlish voice, "That boy doesn't have bowel disease?"

I sense Deer is deeply concerned over that video. Anyone know what's up with that? How does Deer again have what should be confidential medical data on a medical patient? Food allergies causing removal of large sections of the colon? Really?


@ EMF guy and GlaxBrit, re: "it's too late..." and "the sh_t is out" and it's too much to overcome.

It's never too late for people to come forward and do the right thing. I have faith that more people will come forward and attest to their own mistakes as well as those of others.

Doing the right thing, telling the truth, stopping further harm from lies of omission and lies of commission. Most people don't want to go down in history as being immoral, crooked, and dishonest and causing people especially children unneccessary harm.

It's never too late to come clean and tell the truth....

"A yacht captain said on national TV Friday that he lied to investigators about Natalie Wood's mysterious death 30 years ago and blames the actress' husband at the time, Robert Wagner, for her drowning in the ocean off Southern California."


emf guy
Any so called 'investigation' by UCL would be just another Wakefield bashing exercise, as their response to Godlee makes clear; as for a UK Government investigation-forget it. The S&T select committee have now rejected this idea:-
http://www.ucl.ac.uk/news/news-articles/1111/111110-ucl-response-to-BMJ-editorial
10 November 2011

"In relation to the recent BMJ editorial by Dr Fiona Godlee, a UCL spokesperson said:

"Matters relating to alleged research misconduct by Dr Andrew Wakefield are subject to a review which UCL is commissioning, following the receipt last month of independent advice on scope and procedure from the UK Research Integrity Office - an independent body which provides expert advice and guidance about research related conduct.

"We are currently in the final stages of a process to identify a suitable external Chair for the review. We anticipate that its scope and terms of reference, and the full membership of the investigating panel, will be confirmed and the review formally launched by the end of this year. The investigating panel will include other external as well as internal members.

"UCL is conscious of the need to ensure that, once launched, this review is thorough, fair and wide-ranging, and is conducted according to a timely and transparent process. We are taking care to be as thorough as possible in commissioning this review and feel it is imperative that we ensure the probity of this important process. We therefore cannot comment further on specific aspects of the case at this point."

After Godlee's apology I want to see Anderson Coopers and Nancy Snydermans. Gupta and Lauer, too. Those "news" people probably knew exactly what they were getting into when they maligned him so viscously and they are no doubt pressured and paid by pharma. Time to get a backbone people or you will be viewed as a McQuEary.

Jenny Allan

Pardon, my mistake on the Royal Commission in the UK.

We should ALL encourage Pepys at UCL to do the investigation.
Again - having such a grotesquely conflicted group 'beating a dead horse' of this vaccines and autism thing can only help.

They will put on their blinders, wade through the crap and fashion it into a nice clear endorsement of MMR Safety
one again thoroughly bashing Wakefield.

But the chances are, one person will choose to break ranks.

In the main, they are not lying weasels just medical people with blinders on. They are understandably afraid what they know to be true isn't - and their profession has made a big mistake inflicting harm. That's very scary.

So encourage the UCL investigation.

But get the Parliamentary Inquiry done.
If Science & Technology is not the best arm of the UK government, lets' find out which one is.

Ironically, our best partners are our 'enemies'.

Bill Gates says anyone who advocates prudence, anyone questioning the safety of vaccines is a baby killer.

The UK government has a responsibility then to stop the baby killing. The government - not an industry panel or media outlet or 'scientific' publication or journalist - has the responsibility to get to the bottom of this.

Their primary mandate is health and safety of their people.
So let's join hands with the bashers and demand they raise the quality of the investigation. Of course, 'they' want to simply, thoroughly and irrevocably quash dissent. Good.

'Stop the Baby Killers! Demand a Parliamentary Inquiry'
We could get T-Shirts made and sell them on those goofy blogs.

I guarantee you they'll not be able to maneuver their gigantic meandering pile of poop through a genuine government investigation.

Parliamentary Inquiry

Thanks John Stone for another post keeping us up with developments in this debacle.

And here is the big "Gotcha", Doc Godlee. Readers your attention is drawn to "those three things" Dr Godlee referred to in her lecture to the US NIH in Bethesda [reported in AoA here:
http://tinyurl.com/d5yg6rs ].

It seems, Dr Godlee, it was not Dr Wakefield who made changes.

To paper over the cracks Godlee incorrectly claimed to the NIH:

"18.55 "What these articles also say that when those three things didn't come up trumps on the twelve children included, and the subsequent series of children, Andrew Wakefield altered the data to make those three things emerge""

What BMJ and Mr Deer did was the following:-

- they changed what the 1998 Lancet paper actually reported into something else [details below];

- they then claimed what the paper reported [their version, not what it did report] did not match and they cherry-picked evidence from incomplete family doctor records to support this;

- they then claim fraud, without the evidence to back it up - because there has been no fraud [leastwise not by anyone at the Royal Free Hospital].

DETAILS:

Go to the online version of Mr Deer/BMJ's article. There you will find a link to the "Web Extra" document setting out the specific details of what Deer/BMJ allege.

Download it [it's a .pdf].

It has the odd file name "deeb200710.ww1_default.pdf" so you cannot miss it.

Then go to Table 2 and look at the headings. They are:

"(a) Regress autism"

"(b) N/S colitis"

"(c) Within days of MMR"

Those are NOT the categories of FINDINGS and PRESENTATIONS reported in the 1998 Lancet paper.

The novel FINDINGS described in the 1998 Lancet paper were:

"intestinal disease (colitis and/or ileal lymphoid nodular hyperplasia)"

in 12 children whose PRESENTATIONS were that they had “a history of normal development followed by loss of acquired skills, including language, together with diarrhoea and abdominal pain”.

Mr Deer and the BMJ editors changed this to be a FINDING of

A) "non-specific colitis"

in 12 children whose PRESENTATIONS were that they:

B) had autism who regressed:

C) whose symptoms of autism were first indicated within 14 days of the MMR vaccine.

Deer & Godlee then claimed none of the children had all three of those conditions and claimed the 1998 Lancet paper was a fraud.

Ho hum Dr Godlee - what do you say to that? Not a lot we suspect.

And there is another problem coming your way, Doc.

There is no doubt whatsoever that 12 very sick children were seen at the Royal Free. Their story has been repeated tens of thousands of times around the world.

It is now perfectly well recognised in the medical literature that autistic children commonly suffer from bowel problems.

So Doc Godlee, if you or others want to "scientifically peer review" the 1998 Lancet "Early Report" [which itself called for further investigations into the Royal Free findings [a task long suppressed by editors of medical journals and others], you had better come up pretty sharpish with an alternative plausible explanation backed by sound clinical evidence [no more "Tobacco Science" thanks Doc or "genetic gibberish"].

And it is time we had parents queueing up to give and document their account of what happened to their child, the child they saw regress before their eyes shortly after a vaccine.

You see Doc Godlee, the reason why you cannot make this problem go away is because the children aren't. They just keep on coming and they did not before the vaccines were marched out en masse from the mid-1980s.

http://www.bmj.com/content/342/bmj.c5347?tab=responses
Please 'thumbs up' John Stone's new Rapid Response relating Dr Lewis's excellent scientific credentials. It would also be helpful to thumbs up the responses from Prof Shaw, Mark Struthers, Lucja and Viera, and of course David Lewis's letter and please also 'thumbs down' Brian Deer's disgraceful, Murdochesque gutterpress style posting.

http://www.bmj.com/rapid-response/2011/11/17/re-pathology-reports-solve-%E2%80%9Cnew-bowel-disease%E2%80%9D-riddle
Please also support Dr Dhillon with as many thumbs ups as you can muster.

It is VERY important for the BMJ Governors and other 'movers and shakers' in political and pharma sponsored places to understand the public outrage about this whole disgraceful episode.

In this article published in July 2011, Martin Hewitt discusses several of the children, incorporating histology reports and some GMC testimony:

http://www.ageofautism.com/2011/07/time-to-revisit-deer-3.html

I am happy for Dr Wakefield, for truth and for human decency!

Final Submissions - GMC Transcripts

"Professor Walker-Smith told you that it was then that he was informed that Mr Deer was threatening to report Dr Murch and him to the General Medical Council (Day 84/35B).

We remind you of the following evidence given by Professor Walker-Smith during crossexamination by Mr Hopkins:

“Q Would it be right to say – I am dealing with the impact of that meeting – that you, Professor  Murch and indeed Dr Thomson and others, were in a bit of a state of shock at what was being suggested?

A The shock was when the Dean told me that Mr Deer was threatening to report both Professor Murch and myself to the General Medical Council. The whole of the subsequent activity I was under a state of some duress, attempting to do these tasks with that hanging over me.

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


VACCINES CAUSE AUTISM

Dr. Godlee do not apologize to Dr. Wakefield because of pressure from Dr. Dhillon. Apologize for YOURSELF.

That's right be Scientist enough, Doctor enough, Editor enough, Parent enough, wife enough and woman enough to admit you are wrong. Admit that the entire messy affair with Dr. Wakefield and the subsequent paid for pharmaceutical position was taken to cover for your handlers and your lords.

I promise you Fiona you will feel much , much better about yourself. I think then you will be ready to ask God to forgive you for your sins, as killing and maiming children is truly a sin.

Your goal now Fiona is to try and avoid going to HELL for all of the bad things you have done and the children and families that you have hurt

It is not too late Fiona, soon it will be however and when the jig is up and the truth comes out from somewhere else there will be no damage control. I can assure you unlike Penn State there will not be a few thousand students drinking beer and chanting "We want Joe". They will want mob justice, "all the kings horses and all the kings men" and so on and so forth.


VACCINES CAUSE AUTISM

emf guy
We don't have 'Royal Commissions' in the UK any more. In fact The Queen must refrain from involving herself in 'political' issues. Mr Millar MP, Chair of the Parliamentary Select Science & Technology Committee, has just turned down Godlee's request fror a Parliamentary investigation.

UCL, whose Medical Director Professor Mark Pepys set up a 'commercial arm' in partnership with MMR manufacturers GSK, post Wakefield, promised Godlee a UCL investigation following Deer's BMJ articles published in Jan/Feb 2011. Godlee was 'miffed' that UCL had done nothing since then. UCL has now stated that they are looking for a chairman and the investigation will take place next year.

However, in view of the S&T 's response to Godlee and Dr Dhillon's BMJ explanation, it is now clear that the Lancet 1998 Wakefield et al paper was conducted and recorded in accordance with proper scientific procedures. In other words, there is NOTHING to investigate at UCL.

Furthermore, I am quite sure that Prof Pepys will not want too much public scrutiny of his own dealings with GSK, which has discredited James Murdoch as a director. In the UK right now 'Murdoch' links are POISON!!

I am waiting anxiously for the next chapter:-

Dr Godlee apologises to Dr Wakefield!

Elizabeth

Might be a better Christmas for the Wakefield family this year.

Any other Murdoch/Deer wisdom need to be retracted from the BMJ ?


Are the single vaccines for the three MMR viruses available in the UK at this time ??? or is it still just the MMR or nothing ??? What countries have & use the single vaccines ?

so much monkey poop... it's poop wallpaper at BMJ! Any human would admit smelling it.

Glax Britannicus

Agreed.
And don't misunderstand me - John Stone is a champion -
as we all know.

My point is, there are so many untruths spread across so many channels it doesn't matter one whit how foolish Godlee or the BMJ looks to those in these AoA pages. The sh..t is out of the horse and there is no way to get it back in.

One exception ... a Royal Commission could.

Beth

It is a bit late for Godlee to choose: convinced of her own rectitude she has behaved in completely reckless way. Moreover, it has been both a very dirty fight, and a completely unnecessary one. She will have to back-down, but she surely has no more contribution to make. For the other side she has just failed.

It's time to choose.

Are you going to go down in flames with the group of morally compromised people who know that children are being harmed yet who remain silent and let it endure?

Or are you going to do the right thing - unlike those at Penn State - and bring to light what you know now and stop supporting those who have allowed more and more children to become harmed?

It's not too late. You can be a hero. Or you can be a felon if you're in a position of power and could have done something to stop children from being harmed. Or you can explain for the rest of your life how "you just wish you had done more."

Choose your path carefully.

Emf Guy

I suspect that John Stone was just trying to highlight the anomalousness of Godlee's position in a diplomatic way. It is rather a big error to pass over with an apology. She has made her entire organisation look foolish.

Who Cares?

Who cares what plays out on the pages of the BMJ.
If she comes out and apologizes ... who cares?
It will never be covered in the Media and
never overcome the massive media fraud.

What, then a GMC apology is forthcoming?
Let's get real, are we really satisfied with crumbs?

Godlee wants a "Parliamentary Inquiry"

Let's give her a "Royal Commission"

It's one thing to pull this scammery at an industry party like the pretend investigation of the GMC. It's a whole other to perjure yourself at a Royal Commission.

Liars there go to jail.

Demand a "Royal Commission"
It's the answer.

I might be more convinced that Godlee was actually concerned about institutional medical corruption, if she were calling for an inquiry into a medical controversy that was not 13 YEARS OLD! (Or perhaps she really does care about medical corruption and we should invite her to join The Canary Party.)

The pretense of caring about integrity in medicine was paper thin at the outset. Now she just looks silly.

Sorry that this comment was so short, but I have to run off and call for a Congressional inquiry into the affair between Bill Clinton and Monica Lewinsky. I really care about corruption in politics.

It's Chicken Little time!

More from Dr Dhillon's BMJ article 17-11-11:-
http://www.bmj.com/rapid-response/2011/11/17/re-pathology-reports-solve-%E2%80%9Cnew-bowel-disease%E2%80%9D-riddle

"Several expert gastrointestinal pathologists and gastroenterologists have commented on the grading sheets (BMJ Nov 12 2011) and they have stated that the findings cannot be colitis; however:
-It is a mistake to apply uncritically adult gastrointestinal biopsy histopathological thresholds of normality vs abnormality to children
-The expert gastrointestinal pathologist and gastroenterologist commentators have tried to assess the diagnostic implications of data represented in histopathological grading sheets alone
-This is a fundamental mistake: the significance of the histopathological component of any diagnostic equation depends on consideration of the histopathology within the complete clinical context
- The current opinions of the experts regarding the significance of the histology grading sheets are subject to retrospective bias by knowledge of events since 1998."

The BMJ is choking for air in the stratosphere of indulged will, to paraphrase Gore Vidal.

John .. thanks for all you do to keep those of us in the United States informed on this unfolding UK scandal. As I have said before .. just as France unjustly persecuted "Dreyfus" .. the UK has unjustly persecuted "Wakefield".

In any event, it appears Ms. Godlee now finds herself treading the dangerous waters of "coverup" .. where the slow, steady .. "drip, drip, drip" of damaging information .. threatens to become a "rip-tide" .. forever destroying the professional reputations and credibility of all involved .. including the BMJ, Ms. Godlee and Brian Deer himself.

US History teaches .. once a threatened but revered institution .. be it the USS White House under the captaincy of Richard Nixon during Watergate .. or .. in this instance .. the once proud HMS BMJ .. under the captaincy of Ms. Godlee .. begins to sink under the murky waters of "coverup" .. there will ALWAYS be a precious few .. such as .. John Dean in Watergate .. that will refuse to go down with the "sinking ship" .. reluctantly stepping forward .. as a last resort to save their own reputations.

Hopefully, that "precious few" will soon surface to bring an end to this travesty.

UCL lawyers and management have previously prevented histopathologist Dr Dhillion from commenting publicly about Brian Deer's BMJ articles. I think we can all now assume that attitudes at UCL have completely changed, in response to Fiona Godlee's recent attack on the integrity of Dr Wakefield's research and clinical colleagues and senior UCL medical and management personnel.

Dr Dhillon states:-
"My grading sheets were with Andy Wakefield and my general recollection of my impression of my slide review was that some biopsies were a bit inflamed, and others were not: I did not know which case was represented by which set of slides, and which sets of slides were “normal” controls. As far as I recall, the changes were not severe in any of the slides, but it is not unusual for gut mucosal biopsies to show little abnormality even in clinically well defined cases of gastrointestinal disease, particularly in children."

In other words, SOME of these grading sheets were not about the Lancet 12 children AT ALL but were 'control' specimens from children with perfectly normal guts, (as is usual in double blinded studies). Dr Dhillon also makes the point, "it is not unusual for gut mucosal biopsies to show little abnormality even in clinically well defined cases of gastrointestinal disease, particularly in children."

My own autistic grandson, not a Lancet 12 child, but a later case, whose gut biopsies were also analysed by the same team at the Royal Free and who was also diagnosed with ileal-lymphoid-nodular hyperplasia, still suffers terribly with his guts 18 years after administration of the MMR vaccine. I note that Dan Olsmstead's recording of child 11's medical history, after talking to this child's father, noted that child 11 was already diagnosed with a bowel disorder in the US BEFORE becoming a Royal Free patient.

For Godlee and Deer to make such damning allegations against Dr Wakefield's colleagues on the strength of a bundle of unsigned undated tick box forms, without a single child's name on them, will undoubtedly result in repercussions on the integrity of the BMJ and Godlee herself. I honestly think it it too late for this woman to continue as editor of this once prestigious medical journal. The Titanic has hit the iceberg.

There is a fundamental question here. We know now there is going to be an inquiry at University College London, but why does Godlee need one? This is surely because she has failed miserably to establish her case even though she has been blocking free discussion in BMJ's own columns. So now she needs a repeat of the GMC which found all sorts of impossible things to be true. Back in January 2010 the Guardian science correspondent Sarah Boselely - on the evening the GMC brought in its findings on fact - gave the smallest public glimmer that all was not what it seemed ( the behaviour of the Guardian itself remains rotten, through and through):

"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.guardian.co.uk/science/2010/jan/28/andrew-wakefield-downfall

And, of course, no good has. Or in the immortal words of Birdboot in Stoppard's 'The Real Inspector Hound' 'The skeleton in the cupboard is coming home to roost.'

Keep digging, Fiona. Hee hee.

"Godlee has been calling for a further inquiry into the Wakefield affair – it is almost as if having dug herself a pit, she is calling for someone else to pull her out."

-my thoughts exactly.

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