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OBSERVATIONS: Ben Goldacre MMR: the scare stories are back BMJ 2007; 335: 126-127 [Full text]

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Some things are just too attractive to the media

Neville W Goodman   (21 July 2007)

MMR articles in press

Evan L Lloyd   (23 July 2007)

We are owed an explanation Prof Baron-Cohen and Dr Goldacre [1]

John Stone   (23 March 2009)

Selling fear is contempt for the British public

Richard Bartley   (25 March 2009)

Explanations please.

Bill Welsh   (26 March 2009)

Re: Selling fear is contempt for the British public

John A Steward   (30 March 2009)

Some things are just too attractive to the media 21 July 2007
Neville W Goodman, Consultant Anaesthetist Southmead Hospital, Bristol, BS10 5NB Send response to journal: Re: Some things are just too attractive to the media	The Independent on Sunday didn’t even bother to dig up spurious “new” findings in its take on the Andrew Wakefield GMC hearings. Instead, it fell back on the old angle of finding a family wrecked by autism. The headline of its lead News Agenda story (“The people making the headlines in the coming week”) was a quote from a mother of two autistic children: “I wish the GMC could live a day in my life and see what I have seen.” [1] This is presumably a plea that the GMC should exonerate Wakefield. Although the story made all the right noises about the lack of evidence for a link between MMR and autism, and listed the charges against Wakefield, all the emotion in the story was biased. In the centre of the page was a picture of Wakefield, and under it a quote from the story, “My motivation is the suffering of children I’ve seen and the determination of parents to find out why part of them has been destroyed.” The best of motives do not excuse unethical behaviour, which is what the hearings are exploring. In the text but missing from the quote is the phrase “devoted, articulate, rational” parents. I cannot doubt the first two descriptions, but many of these parents are not rational in the sense of being to weigh evidence dispassionately. One only has to see the quote from one parent who is a leading member of a parental support group to realise that. He says, “If Wakefield is struck off it will discourage any doctor from asking questions about the safety of vaccines.” This is an emotional, not a rational, response. The mother who is the focus of the story believes that they could have saved their second child from autism if they had “stuck to our guns” and refused MMR. She says, “That man reported something that parents know in ourselves to be true” - as sure a confirmation of the power of anecdote over evidence as you could wish to see. Meanwhile, on the previous page to Ben Goldacre’s column on this story in the Guardian [2], was a story headed “Ban new homes near power lines, say MPs”. And, sure enough, someone died of brain damage, and a relative is convinced the power lines were the cause. Some things, MMR-autism and power lines-cancer being examples, are just too much of a draw for the media for them to be bothered about getting things right. 1 Independent on Sunday 15 July 2007, p 50. 2 Guardian 18 July 2007, p 10. Competing interests: None declared
MMR articles in press 23 July 2007
Evan L Lloyd, Retired Consultant Anaesthetist 72 Belgrave Road, Edinburgh EH12 6NQ Send response to journal: Re: MMR articles in press	I compliment Dr Goldacre for his destruction of the article in the Observer, and his exposure of the range of insinuations, based on imperfect or discredited science, and complete falsifications used in the article. If a doctor had produced a similar article, and claimed it as fact, he/she would have been disciplined. Maybe the Press Council should consider the matter. However I think the Medical Profession should change tactics. It is perfectly clear, from good science, that MMR does not cause Autism. However autism exists and the medical profession should be asking what is the "real" cause of autism. This approach eliminates the problem of having to decide if there is an increased incidence of autism or only better diagnosis, and can divert scientists, and journalists, onto a tack which might actually produce worthwhile results. Competing interests: None declared
We are owed an explanation Prof Baron-Cohen and Dr Goldacre [1] 23 March 2009
John Stone, Contributing editor: Age of Autism London N22 Send response to journal: Re: We are owed an explanation Prof Baron-Cohen and Dr Goldacre [1]	It is remarkable to note that after the extensive denials surrounding this matter and particularly the 1 in 58 incidence of autism that Baron- Cohen delivered a paper amid little publicity which acknowleged an incidence of 1 in 60 (which sounds like a rounded version of 1 in 58) [2]. The conclusion of the still unpublished paper at International Meeting for Autism Resesearch was: "The prevalence estimate of known cases of ASC, using different methods of ascertainment converges around 1%. The ratio of known to unknown cases means that for every three known cases there are another two unknown cases. This has implications for planning diagnostic, social and health services." [2] This is equivalent to one child in every second class and approximately 1 in 38 boys. Prof Baron-Cohen wrote to the Observer after the publication of the story: "The research is based on a study of Cambridgeshire children, which ran for five years. It has not yet come out with a definitive figure on the prevalence of autism and it is therefore irresponsible to single out one figure. "The best estimate of the prevalence of autism is the 1 per cent figure published in the Lancet in 2006." [3] So, it looks as if there are figures which can be discussed by academics in private and figures which are for public consumption, but which have now seen the light of day in a Daily Mail article [4]. An interesting question is why Baron-Cohen et al think they can project figures taken from a school population onto the entire population as if there was no concern about time trends? This would seem to be based more on ideology than on science. Meanwhile, the arrogant indifference of everyone in authority to parents who report adverse reactions to vaccines followed by the occurrence of ASDs speaks for itself. How bad does it have to get before the autism figures start to matter? [1] Ben Goldacre, 'MMR: the scare stories are back, http://www.bmj.com/cgi/content/full/bmj.39280.447419.59 [2] Baron-Cohen et al, 'Estimating Autism Spectrum Prevalence in the Population: A School Based Study from the UK', International Meeting for Autism Research, 19 May 2008, http://imfar.confex.com/imfar/2008/webprogram/Paper2245.html [4] Simon Baron-Cohen, 'Reasons why autism could be on the rise', Observer Letters 15 July 2007, http://www.guardian.co.uk/news/2007/jul/15/letters.health [4] Sue Reid, 'One Child in 60 Suffers from a Form of Autism', Daily Mail 21 March 2009, http://www.guardian.co.uk/news/2007/jul/15/letters.health Competing interests: Parent of an autistic son
Selling fear is contempt for the British public 25 March 2009
Richard Bartley, Physiotherapist Denbigh Send response to journal: Re: Selling fear is contempt for the British public	Many parents and their advocates (mainly lobbyists) remain suspicious that there is a medical cover up of a possible link between autism and MMR. Although existing evidence suggests there is no link, this is not set in stone, however unlikely future research may prove otherwise. If the press wish to genuinely lobby for its readership it could start by telling the truth. As Ben Goldacre states, quoting hidden research and cherry-picking data simply to sell newspapers is a disservice to both doctors and patients. It does nothing to encourage open minds and a rational approach to such an important public health issue. Instead it hardens sides, pitting genuinely anxious parents against a benign medical establishment, when they should all be working together for the benefit of their children. Competing interests: My children were given the MMR jab.
Explanations please. 26 March 2009
Bill Welsh, President Autism Treatment Trust, 29A Stafford Street, Edinburgh. EH3 7BJ Send response to journal: Re: Explanations please.	The study by Cambridge University’s Autism Research Unit confirming that one child in 60 in the UK has a diagnosis of Autistic Spectrum disorder, (regarded as a lifelong and incurable condition), is a wake-up call to everyone in public health. A once very rare childhood developmental condition has become common in the space of 20 years. Autism is now more prevalent than Spina Bifida, Downs Syndrome, Cerebral Palsy and childhood Leukaemia, combined! In fact we have more children with neurological problems than ever in our history and yet there has been no drive by the medical hierarchy to highlight this tragedy or to properly investigate it. For parents who have watched their child degenerate into autism following MMR it is a powerful first-hand experience. Comparing notes results in finding that other parents have undergone extremely similar experiences. Unfortunately, such experiences are not part of a scientifically-controlled study, so are routinely dismissed as anecdotal. One anecdote is just that: an anecdote. However a consistent pattern of anecdotes is much more powerful. What we have is a consistent detailed pattern of reports from parents. The scientific and investigative importance of this pattern has been unaccountably ignored by the Department of Health. Recent developments in the USA where a child (Hannah Poling 1) was awarded compensation by the US government in recognition that her autism was as a result of multiple vaccination, including MMR, is surely confirmation that those charged with the guardianship of public health have been too quick to dismiss the evidence of parents in favour of government and pharmaceutical funded epidemiological studies. In another, more recent case in the United States Court of Federal claims, a child (Bailey Banks 2) was compensated following the development of Acute Disseminated Encephalomyelitis (ADEM) after MMR vaccination. It was concluded from the evidence provided by a full neurological examination of the child 16 days after his MMR vaccination that the jab had caused ADEM which in turn had led to Pervasive Developmental Delay, a disorder on the autistic spectrum. The ruling was unequivocal. No one wishes to see the return of the three diseases MMR is designed to eliminate but the evidence of many parents that their child was developing normally, meeting all the milestones set for children these days, only to withdraw into autism following the administration of the MMR is overwhelming and compelling. Claims from Professor Simon Baron-Cohen that reported increases in autism are due to ‘better recognition’ or ‘widening diagnostic criteria’ are baloney. Health officials have invested up to £10 million on MMR promotion including a campaign of spin and mis-information. That money and more should have gone into independent clinical research into an MMR/Autism link, after the alarm was first raised by Dr Andrew Wakefield in 1998. Bill Welsh President Autism Treatment Trust 29A Stafford Street, Edinburgh. EH3 7BJ 1) Hannah Poling v United States, Department of Justice, Health & Human Services division. Nov. 9, 2007. 2) Bailey Banks v United States, Department of Justice, Health & Human Services division. (02-0738V) Competing interests: Grandfather to an autistic boy.
Re: Selling fear is contempt for the British public 30 March 2009
John A Steward, Director WCISU 13th Floor Brunel House, Cardiff CF24 0AH Send response to journal: Re: Re: Selling fear is contempt for the British public	It is interesting that the treatment of alleged cancer clusters in North Wales by the press has many parallels with MMR. Erroneous research being picked up by uncritical media looking for a story. Campaign groups are adept at publishing erroneous papers on self publishing websites without any peer review controls and maipulating the gullible media. My unit the Welsh Cancer Intelligence and Surveillance Unit has the correct data and the expertise to analyse cancer clusters correctly. What is worrying is journalist discount our findings as a conspiracy and instead collaborate with badly flawed studies adding to the misinformation and providing the oxygen of publicity. This is all documented in a peer reviewed publication with an editorial. [Links to free downloads reproduced with permission from editor JRP] 1. Steward JA,White C, Ceri; Reynolds S,(2008), "Leukaemia incidence in Welsh children linked with low level radiation—making sense of some erroneous results published in the media", Journal of Radiological Protection 28: 33, 2. Wakeford R (2008), "What to believe and what not to believe", Journal of Radiological Protection 28: 5, [http://www.iop.org/EJ/toc/0952-4746/28/1] Competing interests: None declared