Talk:Andrew Wakefield
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[edit] MMR controversy
The MMR controversy section should be merged into MMR vaccine - there's no point having the information twice. --Khendon 12:47, 1 Apr 2005 (UTC)
- Beg to disagree. That would lead to 'intellectual homogenization', no end of which can be found elsewhere on the net. The facts concerning the MMR controversy have been buried enough by poor reporting in the media. The unique relation of the matter to Dr. Wakefield needs clarification, not further on-line decimation. Ombudsman 21:54, 1 Apr 2005 (UTC)
Fine, reduce the section to clarification of the unique relation, but there's no need to repeat things. --Khendon 07:34, 4 Apr 2005 (UTC)
- Really, it is not OK that:
- This information is mindlessly duplicated in several articles.
- The Andrew Wakefield-related text dominates the MMR vaccine article
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- This material is not as relevant to readers of the MMR vaccine article as its length would suggest. It is longer than anyone needs it to be.
- The detailed article on Andrew Wakefield exists. All that MMR vaccine needs is a paragraph or two on the historical note of Wakefield's controversy. Heathhunnicutt 15:12, 13 June 2006 (UTC)
- On the whole, I agree. Midgley 21:18, 13 June 2006 (UTC)
[edit] Jeff
(revised) Jeff's revisions are dubious at best. Revision of the very first sentence misrepresents the study, which was not about a specific vaccine as implied by the edit. By focusing on its suggestions, rather than the actual study (of the association between a consistent set of bowel disorders and a range of neurodevelopmental syndromes), the edit fails to strike an NPOV balance between reasonable interpretation, and commonsense assessment. The interpretation offered by the authors was that "We have identified a chronic enterocolitis in children that may be related to neuropsychiatric dysfunction," and recommended further study, "Further investigations are needed to examine this syndrome and its possible relation to this (MMR) vaccine." The study did not address whether or not the MMR was the vector involved. The debate over MMR, if you could call it that, became truly irrational only after the government unilaterally took to proffering the MMR, and blocked access to single jabs.
The edits attempt to justify the campaign to smear Wakefield's scientific integrity, by ignoring the fact that proper disclosures were issued and that the Lancet study itself was designed and largely executed prior to the litigation and execution of the second study.
The edits also distort the so called "retractions" by the other authors. The retraction was prompted by government and industry pressure, and only related to the commonsense suggestion that the finding of consistent bowel disorders in the study participants merited further investigation of environmental causes. The retraction had nothing to do with the essential medical conditions at issue.
Also alarming about the edits is the lack of balance portrayed between the risks involved. Mention is added of the allegation that risk may increase for disease that could be prevented, without mention of the iatrogenic risks that have evidently contributed to the autism epidemic. In light of this spin by "Jeff", the following quote from Wakefield loses all touch with its true context, the exponential rise in autism rates.
The anonymous editor, who now goes by "Jeff", included brazen deletions and introduction of POV, consistently favorable to the British government and pharmaceutical industry. In contrast, the UK House of Commons Health Committee, in a recent report, expressed deep concern about each: "The Department of Health has for too long optimistically assumed that the interests of health and of the industry are as one. This may reflect the fact that the Department sponsors the industry as well as looking after health. The result is that the industry has been left to its own devices for too long. It may be relevant that this is the first major select committee inquiry into the pharmaceutical industry for almost one hundred years – the last was undertaken by the Select Committee on Patent Medicines which reported in August 1914." Ombudsman 21:19, 10 Apr 2005 (UTC) (original 21:39, 3 Apr 2005 (UTC))
[edit] Explanation of revisions
I have made substantial changes and corrections to this page, which I believe I have substantially corroberated with links to material. It's clear that Ombudsman has very strong views about MMR, and I think he wishes to use this page as a vehicle for campaigning. I am not a regular contributor to Wikipedia, but I would guess that this is not the purpose of the encyclopedia. As it is, there is a long quote from Wakefield, which I have not removed, even though it is not referenced, and we have no way of guessing whether he said it or not. I have removed long passages about Dr Singh, as he is not a collaborator or even an associate of Wakefield's, his work has not been independently confirmed, and it is about "antibodies to MMR", which most people who know anything about biomedicine will tell you don't exist. If Dr Singh belongs in a biography of Wakefield, then surely there are at least another dozen persons with a better claim. I have also removed claims that Wakefield's Lancet paper has been confirmed by other studies, as I am unaware of any. The only evidence Ombudsman produces that this is so is an article in an Idaho newspaper, reporting something said by a Scottish journalist allegedly said about research. Hearsay upon hearsay. If Ombudsman can cite corroberating papers in journals listed on PubMed, then perhaps he should reference them (although I'm aware that in the 20,000 biomedical journal titles published annually you can usually find someone to say practically anything). Ombudsman will doubtless be very upset again, but I would recommend that he spends a little time reading the Wakefield paper and researching the background before handing down new "facts". For instance, he said the Wakefield paper was not about MMR, and that the vaccine was introduced in 1999. These are pretty basic mistakes. The last time I made corrections, he became very insulting and abusive. I can look at the rest of his contributions to Wikipedia if he would like me to. Otherwise, I suggest that instead of deleting my changes, as he has now done twice, he tries to improve upon them if he can. If he wishes to write a biography of Dr Singh, I will contribute to that also. Jeff. 217.44.174.81 22:07, 6 Apr 2005 (UTC)
- Welcome to the Wikipedia, Jeff. Nice to see your explanation, at last. We have a long way to go, but from your lengthy explanation, now there is rational hope for a meeting of the minds. As time permits, sourcing of any quotes you are seeking will be sought, or you might find them faster by googling. The prop 63 implementation, etc., is taking considerable time right now. Please accept apologies for misconstruing your inexperienced edits. BTW, hairsplitting about the relevance of Dr. Singh's corroboration will work itself out, as Clockwork suggests, but right now the wisdom your deletion is disputed. Wiki on, Sire! Ombudsman 03:34, 7 Apr 2005 (UTC)
- Singh is up there on the priority list, but down a couple of notches from the Geier's, as vulnerabilities to mercury may be a greater contributor to the autism epidemic than live measles vaccines. Also, use of a single source is part of what led to the reasonable misunderstanding of your intent. Brian Deer may be an idealogue, and certainly seems to have let himself become part of the smear campaign against Wakefield. One link that will lead you to a wider palette of source material is Lenny Schafer's archives: AuTeach Ombudsman 03:56, 7 Apr 2005 (UTC)
- The edits incorporate material from a source known to be engaged in an ongoing smear campaign against Dr. Wakefield, and salient material repeatedly has been deleted by Jeff. The reference to the focus of the study has been deleted, in favor of irrelevant highlighting of the "first" finding. Rather than retaining the extremely relevant Singh corroboration (and its ironic timing and significance) distracted focus is placed on a single parent. That is not a rational approach to providing context, it is spin doctoring. Edits to the first sentence evidence distortion, as does deletion of Wakefield's response to the deceptive epidemiological analyses, proffered by those willing to abandon scientific principles for money and the good graces of the pharmaceutical industry. Use of terms such as "admission" and "non-clinical" are gratuitous at best, but typical of someone at the very beginning of the NPOV learning curve. But what is most disturbing is the fact the article is no longer about Dr. Wakefield, and his career and scientific contributions, it is now simply little more than regurgitation of detritus from the ongoing smear campaign against Wakefield. An examination of Brian Deer's reportorial exploits should be posted in his article, instead. Ombudsman 00:10, 8 Apr 2005 (UTC)
- Singh is up there on the priority list, but down a couple of notches from the Geier's, as vulnerabilities to mercury may be a greater contributor to the autism epidemic than live measles vaccines. Also, use of a single source is part of what led to the reasonable misunderstanding of your intent. Brian Deer may be an idealogue, and certainly seems to have let himself become part of the smear campaign against Wakefield. One link that will lead you to a wider palette of source material is Lenny Schafer's archives: AuTeach Ombudsman 03:56, 7 Apr 2005 (UTC)
[edit] sepertate vaccinces
They are availible in the UK. They are not resticted. If you think they are you better contact these people [1][2][3] and tell them they are breaking the law. Of course there was a case where a clinic offering single vaccinations lied about results of immunity tests but that was a one off.Geni 23:18, 17 Jun 2005 (UTC)
Are you getting confused (or being over pedantic) by supply on what we refer to in the UK as a 'Named Patient' basis.
The separate vaccines however, have definitely been removed from the British National Formulary (see page 606 ed. March 2005), and therefore have to be specially imported under those terms together with all the extra costs associated.
If you think about it for a moment... the fuss would not have arisen in the UK if the separate vaccines had not been restricted to ordinary NHS (National Health Service) patients. Also, these offers (the ones you give links to) for single vaccinations - on a named patient bases- also would not have materialised had there been no restriction.
In practical terms then, a family GP in the UK does not now, supply these single vaccines, although in theory, he can prescribe almost anything. Do this make things clear? --Aspro 16:48, 8 August 2005 (UTC)
- I know all this. I also know that the uk is a capitalist country. Just becuase you have to pay for something doesn't mean it doesn't exist.Geni 18:41, 8 August 2005 (UTC)
Do you agree then: that you where being over pedantic -since I don't say that they are totally unobtainable, rather I am explaining or confirming that supply is effectively restricted in the UK; a matter on which you appear to be confused.
And in a sense they no longer 'exist' as they are no longer licensed in the UK, which you could have easily found out for yourself. Instead, your likely to confuse parents over here who are confused enough already.
So, would you allow a member of your family to take a medication that has not been licensed in your country? Well, don't suggest it to us... Is that OK!
If you Google something that seem to be at odds with something someone has written, ask yourself: Who, What, When, Where, Why and How And you might be able to discover more useful info to add, instead of taking things at face value and out of context. --Aspro 21:17, 8 August 2005 (UTC)
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- by the defintion are using we have to add to the article of every single item that has a non zero value in the uk that it is resticted in the uk. We are a capitalist country. The fact that something costs money doesn't mean it is resticted.Geni 21:27, 8 August 2005 (UTC)
I've taken this out.
"Wakefield's medical critics say chance alone would explain the frequent temporal association between vaccination and the appearance of developmental disorders noted by tens of thousands of parents, since autism is commonly first revealed early in the second year of life, when MMR vaccination is routine."
It isn't what I regard as _chance_ that two things which occur at similar times occur at ... well, similar times. "Chance" of course suggests a weak explanation of something for which there is a preferred one proferred. The issue is whether there is a causal association, and given the timing of the event and the disease, the temporal association is not relevant to causality.
This article is not very encyclopedic. —The preceding unsigned comment was added by Midgley (talk • contribs) .
- Well, it does matter epidemiologically. If this is a common response from Wakefield critics, it needs to be cited. I agree that the encyclopedicity of this article is poor. It needs copyediting, sourcing and NPOV. JFW | T@lk 15:14, 5 December 2005 (UTC)
[edit] Presentation of data in graphs
http://www.redflagsweekly.com/articles/2005_mar06_2.html#fig1
The graph held up as having a pronounced multiphasic form - a dip and then rise again - is presented much bigger than the graphs presented as monophasic. Thus any bumpiness in the trends in the latter is made to look much smaller. In addition, the quite wavery - bumpy - UK data is given a straight "trend" line through what is probably a best-fit (assuming the data is jitter around a straight line.) This gives the impression to the eye that it is straighter. The Japanese data, whcih we are told is polyphasic, has no trend line, and it also has no confidence lines on the data points. If the confidence limits are added to it, then it would become apparent that it is less different from the UK data than the text suggests. I have no doubt that any peer-reviewed journal editor would throw the graphs out on any one of those three elements of "advertising". I suspect that if a proper treatment of the data - with all the graphs either having or not having trend lines on, drawn on the same scale and zoomed to the same size, and with confidence limits applied to each data point (preferable), or to none - showed the claimed complex relationships convincingly, that they would have been produced in exactly that fashion. Red Flags as far as I know is an on-line publication, rather than presenting images of printed pages, and thus page-space and layout are no more problems for them than they are for the WP. I invite comments on the graphical treatment of the data in that reference. Midgley 00:28, 18 March 2006 (UTC)
(Pagespace) If you pull the images out and look at them, you find that the actual image size - the rectangle in whcih the graphs are drawn, is really quite similar. But the Honda data is presented as a graph occupying much more of the image area. The others are little shrunken things in the middle of a big blank space. So the explanation for the size is not that that was how much space was available...Midgley 00:35, 18 March 2006 (UTC)
(Confidence limits (sometimes called "error bars")). The UK data - I don't have the raw data used to prepare that graph, but in general - would be for the UK, it seems a reasonable assumption. Call the UK UK_traditional_counties 39 English + 34 Scottish + 13 Irish and I suppose 6 N. Ireland ones = 92 counties (56 000 000), and the Japanese area one county (300 000)... (a rough approximation which someone with population figures to hand can make exact) and we would expect the confidence limits/bars on the Japanese data to be considerably larger although not I think 92 or 150 times larger, than the bars on the UK data. What that means is that if you draw them in, the sharp and precise rises and falls disappear into a general trend and the need for statistics. So why are there no bars on the Japanese data? Perhaps the original publication didn't treat its data statistically and it has just been copied to the Red Flag article? For that we have to go to the Honda et al paper (which is on the Web, but which is not given a link from the Red Flags article, but then no references are.) We can't do it from this WP article either, because the paper to which that Red Flags article is a reply, isn't in the references here. Yet. So from the ref in MMR_vaccine :-
The main graph is presented in Bandolier [graph http://www.jr2.ox.ac.uk/bandolier/booth/Vaccines/noMMR.jpg] [article ] (and inter alia, you might note that it has the rate of MMR immunisations on it, which Edward Tufte might well point to as a more clear way to demonstrate the relationship between the MMR (steep down) and the diseases (wobbly shallow up). If the Red Flags graph had added to that the upward graph of the immunisations that replaced it, that might have been more clear than the boxes that are drawn on it. One would have to try that)
The paper is at http://dx.doi.org/10.1111/j.1469-7610.2005.01425.x which is this moment dead. And it is late. More tomorrow or whenever it appears I expect.
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Here is a reworked pair of graphs, to oppose the difference in presentation in the article they come from.
You see I've enlarged the UK graph to a similar size, removed the straight trend line in it that was drawn in, leaving the fluctuations more obvious. In the other one, the Wakefield version of the Japanese data, I've taken out the connections between data points, and drawn a trend line through them. It isn't a calculated regression line, because absolute precision is not the point. It really does need its error bars on.
Midgley 01:49, 18 March 2006 (UTC)
Can see what Midgley's getting at but either he, or I, am confused. In Honda et al's paper: the Cl seems to refer to the confidence that they have in their figure of 88.5 individuals meeting the diagnose per 10,000 etc. (Guess that the same principle is used for the for the UK graph as the error increases in size with the passage of time and the increase in diagnoses) Wakefield uses their calculated incidence per ten thousand, which is based on absolute numbers. This is solid mathematics - the answers are exact- to as many decimal place that you take them to. There is no point in a confidence level about whether 1 in 250 = 4 in 1000. Rather the lack of certainty here would revolve around the accuracy of each diagnosis and whether the team can count properly, and I feel obliged to give them the benefit of the doubt on both of these should any be voiced. Maybe it would have been better if this study had been written up by a PhD, so as to have made it clearer and easier to read, but it wasn't, so we will just have to try and make sense of it the best we can.--Aspro 19:17, 18 March 2006 (UTC)
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- Confidence limits are confidence limits - it is a while since I looked at this data, but I doubt the publishe dpaper has a different definition of them from the usual one. In two groups of data, if the confidence limits cross then one cannot with confidence say the two groups are different. (For the variable we are measuring etc etc). Small populations of data have wider confidence limits. I'm always intensely suspicious when someon says that they are not doing "statistics" because each of their data points represents an actual event. We might need a statistician to convincingly disentangle this. Midgley 21:27, 13 June 2006 (UTC)
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- Hey Midgley. To save yourself a little effort, you might like to check out the take-up of mumps vaccine in Japan. It's not part of the regular schedule, and has remained flat for decades. It's currently running at about one third of the take-up of MV vaccine. So Wakefield's idea that the kids are getting M-M-R, just like MMR, is more of his usual garbage. His whole assumption is that the kids were all still getting the shots, only not separated by a year as he recommended. Sadly for this tragic character, it's entirely untrue.
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86.134.164.219
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- A reference or pointer to data for that would be really useful/interesting ... Midgley 21:27, 13 June 2006 (UTC)
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- Confidence limits: Honda et al give and I quote: "The cumulative incidence of ASD up to age seven was 88.5 per 10,000 (95%CI,78.1-98.8)" My point is simply: if we were dealing with inanimate objects in controlled laboratory conditions, with measurements take with equipment certified by the National Physical Laboratory then I would allow myself to consider that I may be looking at a possible 'universal' value. However, with biological systems - al naturel, subjected to human judgement on a spectrum with no discernible start or finish. Then I don't think it is worth at this stage pontificating about what these figures mean. Case in point: enough studies have been done on homeopathy to have some come up with the odd positive results to a 95%CI BUT that is a demonstration of chance rather than proof. Lastly: I suspect we may never know this, the potency of the MMR may have been reduced slightly (may be why a second shot has been introduced and one Chinese body suggesting a third). Slight adjustments are allowed under the regs (without re-licensing) and can pose a potential problem with critical dosage drugs like wolfram where the dosage can differ between brands. (without looking it up I think its been found it could be theoretically as much as ten percent or more.)--Aspro 09:32, 15 June 2006 (UTC)
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- Yeah, mumps has to be paid for so its uptake is low. However, what's the point?
- 86.134.164.219 has adopted a Logical_fallacy. If you like, it goes roughly like this: The primary 'antecedent' of the 'augment' is that an inoculation with a live (all be it weakened) immuno-suppressant virus given at the same time as another live virus may possible be responsible for an adverse reaction. The suggestion that the MMR may also do the same serves as the 'consequent', so can Me + R . One can not deny the 'consequent' by introducing Me + R - Mu into the argument because it exists outside as a different 'antecedent'. This different antecedent however, can support the original antecedent if the necessary conditions can be made to line up and agree. (which is what Wakefield has attempted to do) However, the Japanese paper did not address this -nor did it say that it did. It simply compared the effect of withdrawal of the trivalent MMR all in one shot. Therefore, the papers conclusions can not be used to either support or deny the 'original' argument -whilst a reanalyses of the 'raw' data can. PR health representatives are hopeless at applying logic and further muddied the waters with their confused rhetoric. Mumps can be ignored without altering the original hypothesis.--Aspro 10:06, 15 June 2006 (UTC)
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[edit] A puzzling absence
Given that the subject became notable by being one of the authors ("lead author"?) of a paper in the Lancet... is it all strange that the paper in the Lancet is not one of the several references in the article? At least, I looked, and couldn't find it. Midgley 21:57, 13 June 2006 (UTC)
- The explanation appears to be quite simple: The original article direct from the Lancet require registration (albeit free). So, another editor changes the link to one of the anti-vac' sites that has a copy of the paper with some POV preamble. Another editor then objects to this so changes the link to biandeer's web page [4]. As this as includes what some might consider a POV preamble, they promptly revert it back to another anti-vac site; and so on. Some where along the line it got left out all together. (It is cited in places like the '12 Aug 2005' version in the very first paragraph : [5])
- Here is the citation once again; up dated to today's date of last access. Shall we see how long it lasts this time?
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- Wakefield A; Murch S, Anthony A, Linnell J, Casson D, Malik M, Berelowitz M, Dhillon A, Thomson M, Harvey P, Valentine A, Davies S, Walker-Smith J (February 28 1998). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children 637-641. The Lancet - Vol. 351, Issue 9103. Archived from the original on 1998-02-02. Retrieved on 2006-07-01.
- --Aspro 12:10, 1 July 2006 (UTC)
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Frankly, the who discussion about merging the MMRII entry with Wakefields error is an insult to anyone who suffered asceptic meningitis, which some papers count as 32000:1 on Urabe sourced mumps component vaccines. The withdrawal of that 1992 UK vaccine group stands completely independently to anything regarding Autism. By combining the two articles you are merely compunding the injury of "MMRII oh isn't that all about autism or bowels?" ...No it certainly isn't. You should read your research more carefully. Some of the key figures in undermining Wakefield such as Elizabeth Miller were also key in getting the Urabe vaccine banned.