Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
Professor Wright is no stranger to controversy when it comes to scientific integrity1, but he is sailing precariously close to the cliff in what I think is his spirited defense of his once next-door neighbour Andrew Wakefield.
In his Editorial, addressing the shortcomings of the transparency of handling of the histopathology process in the Wakefield MMR saga, he is absolutely correct that the histopathologists must take full responsibility for their part of the study. They have regrettably not done so and distanced themselves from the Lancet paper2.
However Professor Wright then invokes Professor Walker Smith’s concerns about the competence of the Royal Free’s pathology services (most hospital have clearly defined pathways to deal with such governance issues), as if this justified altering the initial diagnostic histopathology reports by the other investigator(s) who may not have been accredited in histopathology.
I was a one-time “collaborator” to Wakefield’s group, advising on quality of data underlying the concept of “autistic enterocolitis” including assessing the validity of techniques used for studying small bowel function in this putative condition, the interpretation of the results and whether there were plausible mechanistic links between gut inflammation and CNS symptoms in these patients. I assessed the references cited by Professor Wright and many more and concluded, unlike the Professor (who is not a small bowel expert Gastroenterologist), that there was no justification for the term whatsoever.
Needless to say none of my suggestions for change were acted on, my name was removed from the draft paper and our “collaboration” was terminated. The histopathology part of the MMR case although riddled with irregularity, not least the disappearance of the paraffin blocks and slides, is only one piece of evidence presented to the GMC. It is the repeated irregularities throughout entirety of the case that are so worrying.
Certainly science is a self-correcting process but defective scientific integrity is not and hence the need for the GMC. Sadly for our brotherhood the case was brought about by an astute journalist, which is symptomatic of our complacency when it comes to integrity.
2. Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 1998;351:637-41
Professor Ingvar Bjarnason Department of Gastroenterology King’s College Hospital Denmark Hill London SE5 9RS
This is a curious editorial from Sir Nicholas Wright, presumably
commissioned by the BMJ in an attempt to balance the extraordinary
accompanying article by journalist, Brian Deer. What is particularly
curious is the way Sir Nicholas emphasises that Wakefield was not formally
trained as a pathologist, was not a professional pathologist and was a
surgeon, not a pathologist, as pointed out three times by Deer. However,
as I understand it, Andrew Wakefield became a fellow of the Royal College
of Pathologists in November 2001 in recognition of his research
publications. [1] No doubt the Royal College of Pathologists would feel
slighted at the suggestion that they might throw fellowships at academic
lightweights.
Does autistic enterocolitis exist?
Professor Wright is no stranger to controversy when it comes to scientific integrity1, but he is sailing precariously close to the cliff in what I think is his spirited defense of his once next-door neighbour Andrew Wakefield.
In his Editorial, addressing the shortcomings of the transparency of handling of the histopathology process in the Wakefield MMR saga, he is absolutely correct that the histopathologists must take full responsibility for their part of the study. They have regrettably not done so and distanced themselves from the Lancet paper2.
However Professor Wright then invokes Professor Walker Smith’s concerns about the competence of the Royal Free’s pathology services (most hospital have clearly defined pathways to deal with such governance issues), as if this justified altering the initial diagnostic histopathology reports by the other investigator(s) who may not have been accredited in histopathology.
I was a one-time “collaborator” to Wakefield’s group, advising on quality of data underlying the concept of “autistic enterocolitis” including assessing the validity of techniques used for studying small bowel function in this putative condition, the interpretation of the results and whether there were plausible mechanistic links between gut inflammation and CNS symptoms in these patients. I assessed the references cited by Professor Wright and many more and concluded, unlike the Professor (who is not a small bowel expert Gastroenterologist), that there was no justification for the term whatsoever.
Needless to say none of my suggestions for change were acted on, my name was removed from the draft paper and our “collaboration” was terminated. The histopathology part of the MMR case although riddled with irregularity, not least the disappearance of the paraffin blocks and slides, is only one piece of evidence presented to the GMC. It is the repeated irregularities throughout entirety of the case that are so worrying.
Certainly science is a self-correcting process but defective scientific integrity is not and hence the need for the GMC. Sadly for our brotherhood the case was brought about by an astute journalist, which is symptomatic of our complacency when it comes to integrity.
1. Wright NA. Duplicate publication: additional comments. Gastroenterology. 1995;108:950
2. Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 1998;351:637-41
Professor Ingvar Bjarnason
Department of Gastroenterology King’s College Hospital Denmark Hill London SE5 9RS
Ingvar.bjarnason@kcl.ac.uk
Competing interests: None declared
Competing interests: No competing interests