Why did the Lancet take so long?

Trisha Greenhalgh: competing interests

24 February 2010

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

Competing interests: None declared

John Stone, Contributing editor: Age of Autism

London N22

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