Managing Editor's Note: This post first ran in March, 2010.
By John Stone
Sir Crispin Davis, until recently chief executive of Reed Elsevier which owns the Lancet, failed to disclose his own conflicts while denouncing Andrew Wakefield to the House of Commons Science and Technology Committee in March 2004. Sir Crispin failed to disclose either that he was a non-executive director of MMR defendants, GlaxoSmithKline, or that it was his own brother Sir Nigel Davis who had endorsed the Legal Services Commission’s decision to pull the plug on the funding of the case in the High Court 3 days before (HERE).
This was barely more than a week after allegations had been levelled against Wakefield by Lancet editor Richard Horton, and Sunday Times journalist Brian Deer. Nor do Davis’s conflicts ever seem to have been mentioned by Horton.
Remarkably, these relationships had been mentioned in Sunday Times article about Sir Crispin, just weeks earlier:
"Davis’s only other City job is as a non-executive board member at Glaxo Smith Kline, a position he secured last year."
This did not stop Sir Crispin accusing Wakefield as he was cross-examined before the committee by Dr Evan Harris MP who had accompanied Deer to the Lancet offices 12 days earlier. He told Harris:
“At the time of the submission of the article there was no admission of conflict of interest. Three months later there was a written letter. I think I have got it somewhere here.“
To which Harris interjected:
“I have it here as well, 7 May 1998.:
And Davis responded:
"It actually says, 'There is no conflict of interest'. Should the editor then—"
However, what the interchange hides is the fact that Wakefield disclosed his involvement with the litigation while denying that there was a conflict - all of which had anyway long been known to the Lancet (AoA Smoke and Mirrors , AoA The Last Day of Wakefield's Defence). In the letter published on 2 May 1998 Wakefield had stated:
"A Rouse suggests that litigation bias might exist by virtue of information he has downloaded from the internet: from the Society for the Autistically Handicapped. Only one author (AJW) has agreed to help evaluate a small number of these children on behalf of the Legal Aid Board. These children have all been seen expressly on the basis that they were referred through normal channels (eg, from general practitioner, child psychiatrist, or community paediatrician) on the merits of their symptoms. AJW has never heard of the Society for the Autistically Handicapped and no fact sheet has been provided by them to distribute to interested parties. The only fact sheet we have produced is for general practitioners, which describes the background and protocol for the investigation of children with autism and gastrointestinal symptoms. Finally all those children referred to us (including the 53 who have been investigated already and those on the waiting list that extends into 1999) have come through the formal channels described above. No conflict of interest exist."
Davis’s evidence was defective in not mentioning that Wakefield had made a disclosure while denying – correctly – that there was any conflict in the paper (nor was he corrected by Harris). He was also wrong in implying that Wakefield had taken 3 months to respond. The letter was published only 9 weeks after the original paper, and was responding to a letter from Dr Rouse dispatched only four days after publication, the delay being determined entirely by the Lancet and not by Wakefield.
The delay quickly became a key part of the Lancet’s defence, with Horton claiming that he took Wakefield to mean that he had been engaged by the Legal Aid Board after the publication of the paper. Horton responded to Wakefield in the Journal on 17 April 2004:
"We do not accept Andrew Wakefield and colleagues' interpretation of the letter published in The Lancet on May 2, 1998,..which was, in any event, only published 3 months after the original 1998 Lancet paper."
And when Horton was examined by Sally Smith QC at the GMC in August 2007 the delay was beginning to extend to four months:
“Smith: Looking at the wording of the sentence you referred to "only one author that agreed to evaluate a small number of these children on behalf of the Legal Aid Board", you say you took that to mean since the publication of the paper and we are now some three or four months on.”
To which Horton responds with a single word:
“Yes” (First amended complaint). This delay – which seems to have been so important to Horton’s and the Lancet’s case against Wakefield - has never had any basis in fact.
John Stone is UK Editor for Age of Autism.