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Brian Deer Fantasist: ‘Taking on the Establishment’

Brian Deer LaCrosse Oct 5 2012By John Stone

Brian Deer's forthcoming presentation at the BMJ/Oxford conference is entitled 'Taking on the establishment - investigative journalism'. In this regard it may be helpful in documenting just how fanciful this claim is to revisit my letter to BMJ published after a two week tussle with them in February 2010. And just to consider the great champion of the ordinary citizen against the over-powerful is still at top table in Oxford in 2013!

........................................

Trisha Greenhalgh's competing interests  

Prof Greenhalgh [1] does not disclose any competing interests. She has, however, contributed a controversial article [2,3] attacking the 1998 paper [4] to journalist Brian Deer's website. Although not disclosed here by Greenhalgh or in the accompanying article by Deer [5], Deer was named as a complainant against Andrew Wakefield in the High Court by Mr Justice Eady, who stated [6]:

"Well before the programme was broadcast [Mr Deer] had made a complaint to the GMC about the Claimant. His communications were made on 25 February, 12 March and 1 July 2004. In due course, on 27 August of the same year, the GMC sent the Claimant a letter notifying him of the information against him."

Since 2003 Greenhalgh has benefitted from more than £1.4m in research grants from the Department of Health [7]. When Deer's original allegations were published in the Sunday Times in February 2004 he was supported by the then Prime Minister, Tony Blair, who told ITV [8]:

"There is absolutely no evidence to support this link between MMR and autism. If there was, I can assure you that any government would be looking at it and trying to act on it. I hope, now that people see that the situation is somewhat different to what they were led to believe, they will have the triple jab because it is important to do it."

and by Chief Medical Officer, Sir Liam Donaldson, who told the BBC [8]:

"I don't think that spin and science mix. If they are mixed, it is a very unfavourable position for children's health. Now a darker side of this work has shown through, with the ethical conduct of the research and this is something that has to be looked at."

and Jeremy Laurance reported in the Independent [9]:

"At the Department of Health, which has striven for the past six years to bolster public confidence in the vaccine, joy is unconfined at the discrediting of Andrew Wakefield, as the researcher responsible for the scare."

Meanwhile, Health Secretary John Reid asked the GMC to investigate [10].

I express concern that conflicts that go up to the highest ranks of government are still conflicts, that the government itself is not a disinterested player, and has not behaved like one. At the same time Prof Greenhalgh's research has benefitted hansomely from its largesse. I believe there should be an inquiry.

[1] Trisha Greenhalgh, Why did the Lancet take so long? BMJ 2010; 340: c644

[2] Professor Trisha Greenhalgh. Analysis of Wakefield MMR study asks why flaws weren't spotted by Lancet editors. April 2004. http://briandeer.com/mmr/lancet-greenhalgh.htm

[3] Mark Struthers, 'Unfonded and Unjust' BMJ Rapid Responses 8 February 2010 http://www.bmj.com/cgi/eletters/340/feb02_4/c644#230993

[4] Wakefield et al, 'Ileal-lymphoid-nodular hyperplasia, non- specific colitis, and pervasive development disorder in children, THE LANCET, Vol 351, p.637-41, February 28, 1998 637

[5] Brian Deer,'Reflections on Investigating Wakefield' Published 2 February 2010, doi:10.1136/bmj.c672

[6] Melanie Phillips, 'A deer in the headlights', The Spectator 16 February 2009, http://www.spectator.co.uk/melaniephillips/3362116/a-deer- in-the-headlights.thtml

[7] Profile: Prof Trisha Greenhalgh: Funding Received: http://myprofile.cos.com/P243302GRa

[8] James Meikle, 'Claim that MMR work mixed science and spin', Guardian 24 February 2004, http://www.guardian.co.uk/uk/2004/feb/24/science.sciencenews

[9] Jeremy Laurance, 'Ministers temper their triumphalism but delight spreads at Whitehall', 24 February 2004, http://www.independent.co.uk/news/uk/politics/ministers-temper-their- triumphalism-but-delight-spreads-at-whitehall-571091.html

[10] BBC NEWS, Top doctor wades into MMR debate', http://news.bbc.co.uk/1/hi/health/3512195.stm

Competing interests: Autistic son

To complain about Deer’s appearance in Oxford next month write to his hosts (Centre for Evidenced Based Medicine) Dr. Carl Heneghan, Director of the Center for Evidence Based Medicine carl.heneghan@phc.ox.ac.uk , Prof. Richard Hobbs, Head of Department, Primary Health Care Sciences richard.hobbs@phc.ox.ac.uk , Dr. Rafael Parera rafael.perera@phc.ox.ac.uk , Dr. Matthew Thompson matthew.thompson@phc.ox.ac.uk  and Dr. Amanda Burls Amanda.Burls@phc.ox.ac.uk  .

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The idea that vaccine safety advocacy is the "establishment" is hilarious. Transparent, shameless pandering to progressives. Deer confuses being sordid and a subaltern operative working against public interest like David Ferrie-- someone who cannot exist or operate above board or in daylight-- with being counter-establishment.

Between April 2004 and sometime after February 2010, Brian Deer ‘took on the establishment’ by providing cover for ‘Greenhalgh’s follies’. The ‘tiny fantasy fig leaf’ was then torn away, revealing nothing.

http://briandeer.com/mmr/lancet-greenhalgh.htm

Now is the time to expose the ugliness of those academic misinterpretations in all their grotesquely deceptive glory.

Below is the Greenhalgh folly,

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

A critical appraisal of the Wakefield et al paper

The term ‘critical appraisal’ means a systematic analysis of a study that has been published in a scientific journal (or a study submitted to a scientific journal whose authors seek to publish it), using a checklist of key questions. When a scientist submits a paper to the Lancet, it is sent out to two or more reviewers with expertise in the field, who are required to send back a formal report based on a critical appraisal checklist.

1. Is the topic area important and relevant to the Lancet’s readership?

Yes. In 1998, MMR vaccine had recently been introduced in the UK. Autism was rising in incidence. Questions were being asked about a possible link. A paper describing a study that explored this link would certainly have been appropriate to the Lancet and highly relevant to a general medical readership, so long as it was scientifically robust.

2. Was the study original?

Yes. At the time, no previous study had explored in this way the link between MMR vaccine, bowel problems and autism in children.

3. Was the research hypothesis clearly stated?

No. The paper does not state a research hypothesis at all. Implicitly, the research hypothesis might be stated, “The administration of MMR vaccine to infants increases their risk of developing (a) a particular pattern of inflammatory damage in the gastro-intestinal tract and (b) autism or an autism-like syndrome.”

4. What was the study design?

The study design was a descriptive report on 12 children who had been referred to a paediatric gastroenterology clinic with both bowel symptoms (diarrhoea, abdominal pain, bloating, and food intolerance) and pervasive developmental disorder characterised by loss of skills that had been previously acquired. Various blood tests, gastrointestinal biopsies, and a sample of cerebrospinal fluid were taken from the children. The samples were examined to explore the extent of inflammatory reaction in the bowel and to exclude other diseases (such as thyroid disease, inherited metabolic syndromes and so on). Of dozens of tests done on each child, a number were abnormal, though no test was consistently abnormal in all the children. Eleven of the 12 children had microscopic evidence of inflammatory reaction in their bowel. The parents were asked to remember back and identify if and when MMR vaccine was given. In 8 of the 12 children, the onset of developmental delay was said to have occurred within 2 weeks of having the MMR vaccine, and in 3 it was said to have occurred within 48 hours.

5. Was this design an appropriate way to test the research hypothesis?

No. If the hypothesis was that there is a causal link between MMR and autism-bowel syndrome, this study design was incapable of proving that link one way or the other.
There are six main reasons for this:

The sample was highly selected – that is, the authors deliberately picked out the tiny number of children who had been referred to a major specialist centre because they had both bowel symptoms and an autism-like syndrome. So the fact that these rare conditions occurred together proves nothing at all. The fact that children with diarrhoea or other chronic gastro-intestinal symptoms have microscopic evidence of inflamed bowels is also, in itself, unsurprising.

The sample was extremely small. I would expect a scientific study claiming a causal association between two events (in this case, giving MMR vaccine and developing autism-bowel syndrome) to have a formal statistical calculation of the number of individuals that ought to be looked at. This is known as a power calculation. The reason why the Lancet does not normally publish studies on just 12 individuals (the usual number of research participants is several hundred, and not uncommonly, several thousand) is that the smaller the study, the more likely it is that an apparent causal link will turn out to be due to chance association.

The study had no control group. When studying the possible harmful impact of a vaccine or environmental agent, it is standard scientific practice to include a control group of individuals who have not been exposed to the putative harmful agent. Indeed, epidemiologists can occasionally perform robust studies to explore the causes of rare but devastating events when only tiny numbers of individuals are affected (this was done, for example, to explore the possible link between overhead power lines and leukaemia) by carefully matching these individuals with others who are alike in many ways (age, sex, social class, smoking status and so on) but who have not been exposed to the putative causal agent. This sort of design is known as a case control study. No matching was not done by Wakefield and colleagues, which means we have no way of knowing that the unusual combination of bowel disease and autism-like syndrome might be equally frequent in children who had not received the MMR vaccine.

The alleged link with MMR vaccine was made on the basis of retrospective parental recall – in other words, parents (who had just signed a consent form to take part in a study of whether there is a link between MMR and autism) were asked to consider how closely in time the vaccine was with the onset of autism-like behaviour pattern in their child. Whilst there is no suggestion that parents deliberately fabricated the closeness of the link, the authors of the paper took no steps to guard against what is known as ‘recall bias’ (that is, remembering a closer association between two events than actually occurred). The notion that a previously healthy child was ‘normal’ one day and showed clear signs of autism the next day is at odds with the clinical course of pervasive developmental disorder. Such syndromes tend to have a period of weeks or months during which the child’s behaviour is causing some concern but is not clearly abnormal. Hence the firm statement of a “48 hour” or “2 week” interval between the administration of the vaccine and the diagnosis of autism is scientifically implausible and requires further explanation.

The follow-up period during which the children were studied was short – days or weeks rather than months or years.

The investigators were not ‘blinded’ – that is, the people who examined the children and analysed the specimens all knew that the children had received MMR vaccine and that a question had been raised about the its link with autism-bowel syndrome. They would also have been aware that ‘positive’ findings would be highly likely to lead to a prestigious publication whereas ‘negative’ findings would not. In a scientifically robust study, the people who do the tests should be unaware of the status of the samples.

6. Were the study’s conclusions supported by the data?

No. Whilst Wakefield and colleagues stated at one stage in their paper that their findings did not prove a causal link between MMR vaccine and autism-bowel syndrome, the overall tone of the paper strongly suggests that they believed that they had demonstrated such a link. This conclusion is unjustified for the reasons given above.

7. If the answer to (5) is no, would a more robust design have been practically possible to test the study’s main hypothesis?

Most certainly, yes. It is worth noting the key principles, set out by Sir Austin Bradford Hill in 1965, of any scientific study that seeks to prove causation rather than merely association:

Is there evidence from true experiments in humans?
Is the association strong?
Is the association consistent from study to study?
Is the temporal relationship appropriate (i.e. did the postulated cause precede the postulated effect)?
Is there a dose-response gradient (i.e. does more of the postulated effect follow more of the postulated cause)?
Does the association make epidemiological sense?
Does the association make biological sense?
Is the association specific?
Is the association analogous to a previously proven causal association?

A study from Finland, designed to be large enough pick up even very rare events, followed 1.8 million children prospectively from the day they received the MMR vaccine for a full 14 years. The total number of reported vaccine-associated events was 437, and they included allergic reactions and convulsions, but none of the children had autism linked with the vaccine.

Several subsequent studies, all much larger and better designed than Wakefield’s, have confirmed an absence of excess cases of autism or bowel disease in children who have received MMR vaccine. In 1999, for example, Dr Brent Taylor looked at 500 cases of autism in the Royal Free Hospital and found no excess in immunised children. A very large and well designed study in the USA – with a proper case control design and with all vaccination dates confirmed by medical records – looked at the incidence of inflammatory bowel disease in people who had received MMR vaccine, other measles-containing vaccine, and no vaccine. The risk of inflammatory bowel disease was the same for vaccinated or unvaccinated people. The average time between vaccination and the development of bowel disease was 12 years. Only 1% of cases developed inflammatory bowel disease within a year of vaccination – and 1% of controls developed inflammatory bowel disease during the same time period. This study was cited in the medical journal ‘Bandolier’ and its results are available free online on http://www.jr2.ox.ac.uk/bandolier/index.html

In conclusion, the Wakefield study was scientifically flawed on numerous counts. I am surprised that neither the editor nor the reviewers spotted these flaws when the paper was submitted. Had they done so, the public would have been saved the confusion and anxiety caused by false credibility conveyed by publication of the study in this prestigious journal.

Professor Trisha Greenhalgh OBE MD FRCP FRCGP,
Professor of Primary Health Care and Director, Unit for Evidence-Based Practice and Policy, University College London

[1] This combination has been given the informal name ‘autism-bowel syndrome’ though no such syndrome is officially accepted in the mainstream medical literature

[2] Bradford Hill, A, 1965. The environment and disease: association or causation? Proceedings of the Royal Society of Medicine. Volume 58, 295-300, cited with permission in Greenhalgh T, How to Read a Paper: the basics of evidence-based medicine; London: BMJ Publications, 2nd edition 2002

[3] A Patja et al. Serious adverse events after measles-mumps-rubella vaccination during a fourteen-year prospective follow up. Pediatric Infectious Diseases Journal 2000 19: 1127-1134.

[4] B Taylor et al. Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Lancet 1999 353: 2026-2029.

[5] RL Davis et al. Measles-mumps-rubella and other measles-containing vaccines do not increase the risk of inflammatory bowel disease. Arch Pediatr Adolesc Med 2001 155: 354-359

Ohhhh Mark;
Such a description of Brian Deer!
Loved it!

Are we (parents) that much of a threat to the industry?

I am finding that when I mention vaccine injuries, so many more people are aware of it.

Thanks John.

Elizabeth Gillespie

The reality is that Brian is the tiny fantasy fig leaf that covers the grotesque ugliness of the medical establishment. Shocking!

This is all unfathomable in more ways than one, but mostly that the establishment "takes on" Deer as some kind of shield? or weapon? for themselves.

Fantasist is right. Among his many fantasies is that he's a woman named Becky Fisher, a profane blogger and Mom who for some inexplicable reason is drawn to writing obsessively about the Wakefield affair from the exact same point of view as Brian Deer. Coincidentally, Becky despises all of the people who criticize Brian Deer. Now why would an ordinary mom of an unaffected child take on Brian Deer's fight with such vigor?

You can't make this stuff up. (Only Brian can.)


This "journalist" makes a complaint, then reports on the effects of the complaint, and then declares there is no conflict of interest. Apparently he has not discerned that loss of journalistic integrity and financial gain are competing interests.

I thought I would re-post a comment I made in reply to Mark Struthers 3 days ago regarding the probable reasons why Deer thinks he is embattled with the "establishment", which of course has a lot to do with the fact the fact they have been trapped by him into the endless defense of the false narrative he'd created:-

Mark

Of course Deer started to peddle this nonsense some while back. http://www.guardian.co.uk/science/blog/2011/jan/12/andrew-wakefield-fraud-mmr-autism

Could it be that the luminaries of the British establishment that he defeated included Ben Goldacre, Michael Fitzpatrick and Fiona Godlee (not to mention Jeremy Laurance kite flying at the Independent on behalf of someone or other, perhaps David Salisbury), all of who were getting cold feet at the stupidity of GMC prosecution in 2006 and who are now stuck with the awful results, Goldacre and Fitzpatrick particularly silent since the full exoneration of John Walker-Smith, and Godlee further up a tree than anyone would ever have thought possible?

http://www.ageofautism.com/2012/02/the-walker-smith-appeal-the-british-media-and-the-boseley-problem.html

Even Paul Offit was off-side according to Deer because of his less than fulsome welcome to the GMC findings, also no doubt worried that they would come unstuck.

The truth is that in 2005 Goldacre - the son of an Oxford professor of public health and a government scientist - tried to warn the world that the Wakefield/Lancet paper was a perfectly good piece of work, and even seems to have got the support of Oxford's political scientist Evan Harris MP, who had earlier backed Deer, as of course they all would in end after the GMC got underway. There is no doubt that Deer resented all this, but now they are stuck with him (and serve them right).

I notice that they have tucked him away at the end, presumably allowing people to sneak off back to the airport or London (Goldacre with his new position at the London School of Hygiene and Tropical Medicine).

http://www.ageofautism.com/2013/01/not-all-mercury-is-toxic-desperate-throw-in-new-scientist-to-prevent-un-ban.html

John

Jenny

Regarding the sinister role of Tony Blair in these events readers might like to visit these three articles from the Mail:

MMR Jab: Cherie relative is autism victim (undated but c. Dec 2001)

http://www.dailymail.co.uk/news/article-91387/MMR-jab-Cherie-relative-autism-victim.html

MMR Jab: Why is no one allowed to question MMR? (29 Feb 2004)

http://www.dailymail.co.uk/debate/columnists/article-259834/Why-allowed-question-MMR.html

Former science chief: 'MMR fears coming true' (22 March 2006)

http://www.dailymail.co.uk/health/article-376203/Former-science-chief-MMR-fears-coming-true.html

John

Great letter John Stone......and even after all this time I was able to 'thumbs up' it on BMJ online.

Yes, some people in very high places have extolled and endorsed Brian Deer, including a former Prime Minister, Health Minister and Chief Medical Officer. When the 'House of Cards' comes crashing down these persons will be publicly exposed for their hypocritical and dangerous endorsement of an officially 'admitted to be not fully tested' vaccine.

I was particularly disgusted by the quote (repeated below) from Tony Blair, who refused to tell us in 2002, whether or not his own infant son Leo had received the MMR vaccine. His excuse was Leo's so called privacy, but by NOT disclosing, PM Mr Blair caused a large 'dip' in the uptake of MMR vaccine in the UK. This has never been officially acknowledged by the UK health 'establishment' which blames Dr Wakefield at every opportunity, but parents drew their own conclusions about Leo's vaccinations.

The truth of course is that Dr Wakefield NEVER advocated not immunising children, just a temporary return to single vaccinations until more research was carried out. It was the UK Government which foolishly withdrew the NHS choice of single vaccines, forcing concerned parents to pay £hundreds for single vaccinations privately. Tony Blair could afford it, but most parents couldn't.

Blair's quote:-
"There is absolutely no evidence to support this link between MMR and autism. If there was, I can assure you that any government would be looking at it and trying to act on it. I hope, now that people see that the situation is somewhat different to what they were led to believe, they will have the triple jab because it is important to do it."

know more about Autism solutions http://bit.ly/14GWk7I

On Oct 4, 2012, Brian Deer spoke at the University of WI-La Crosse. I was there and I wrote about his lecture.
http://www.ageofautism.com/2012/10/brian-deer-at-the-university-of-wi-la-crosse-an-elaborate-fraud.html

Read what he had on screen from his power point as the crowd entered the auditorium.

Will he begin his BMJ/Oxford conference in the same crude and offensive manner?
Anne Dachel, Media

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