Intended for healthcare professionals

Rapid response to:

Observations GMC Wakefield Verdict

Why did the Lancet take so long?

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c644 (Published 02 February 2010) Cite this as: BMJ 2010;340:c644

Rapid Response:

The good, the bad and the ugly side of medical science

Dr Ben Goldacre, sometime correspondent for the BMJ and author of the
‘Bad Science’ column in Guardian once wrote,

"Now, even though popular belief in the MMR scare is - perhaps -
starting to fade, popular understanding of it remains minimal: people
periodically come up to me and say, isn't it funny how that Wakefield MMR
paper turned out to be Bad Science after all? And I say: no. The paper
always was and still remains a perfectly good small case series report,
but it was systematically misrepresented as being more than that, by media
that are incapable of interpreting and reporting scientific data." [1]

While acknowledging that the case series provides weak scientific
evidence, Professor Greenhalgh, in her widely acclaimed book on the basics
of evidence-based medicine, gives a good example of the case report
providing an early warning of vital importance to science and public
health,

“A doctor notices that two babies born in his hospital have absent
limbs (phocomelia). Both mothers had taken a new drug (thalidomide) in
early pregnancy. The doctor wishes to alert his colleagues worldwide to
the possibility of drug-related damage as quickly as possible.” [2]
Professor Greenhalgh goes on to say that “anyone who thinks ‘quick and
dirty’ case reports are never scientifically justified should remember
this example.” I am therefore somewhat surprised that Professor Trisha
Greenhalgh should have considered the retraction of a perfectly good small
case series report a good thing for science.

[1] Ben Goldacre. Don't dumb me down. We laughed, we cried, we
learned about statistics ... 8 September 2005.
http://www.guardian.co.uk/science/2005/sep/08/badscience.research

[2] Trisha Greenhalgh. How to Read a Paper. BMJ Publications, Third
edition 2006 Sections 3.7 & 3.8, Pages 52-53.

Competing interests:
None declared

Competing interests: No competing interests

08 February 2010
Mark Struthers
GP and prison doctor
Bedfordshire mark.struthers@which.net