The big breaking news today is actually neither news nor breaking to many of us who have been following this story over the years. Andrew Wakefield had been determined to be a fraud for the misuse of patients--children, the breach of medical ethics, and the harmful assault on the wider public health. As most of you know, his paper in the late 1990s purportedly linking vaccines and autism is bunk, but had unfortunate influence on many susceptible parents. This caused vaccination rates to drop markedly in the UK and the US, and has lead to the deaths of children from diseases that should be preventable.
Today the BMJ, the British Medical Journal, released an editorial and the beginning of a series exploring this topic.
You can obtain the BMJ editorial in full here: Wakefield’s article linking MMR vaccine and autism was fraudulent. You can get the expose by Brian Deer here: How the case against the MMR vaccine was fixed.
I'm not going to argue about the issue of autism and vaccines. The data is there, and you can access the new items in full. This diary is about the dangerous strategy of running with conclusions. And what I mean by that is something we can actually learn from the Wakefield debacle.
From the BMJ editorial:
Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross.
There was a conclusion that Wakefield wanted to assert. And he fit the data to that. This is wrong, it's unethical, and it's a really bad idea.
Also from BMJ:
Authored by Andrew Wakefield and 12 others, the paper’s scientific limitations were clear when it appeared in 1998. As the ensuing vaccine scare took off, critics quickly pointed out that the paper was a small case series with no controls, linked three common conditions, and relied on parental recall and beliefs.
This paper was published (but since retracted). Although we appreciate the process of peer review in science, it isn't perfect--it is possible to get well-constructed fakery through. But the thing about science is that we replicate. We scrutinize, critically. We expand to larger studies. We look at more data. And sometimes we find initial observations don't hold up. We will get to the facts. (However, it is generally not the next day--which is the timescale of the blogosphere....)
The warning flags for taking this paper and making sweeping conclusions were already up early on. This was a small study. There were no controls. There were parental anecdotes. Most of us who read a lot of science would recognize these issues. But this won't stop everyone. It went viral--to use an unfortunate pun.
This had real consequences. Parents stopped vaccinating at rates that endangered public health--and continues to do so today. It has created a whole range of CT the impairs the efforts of public health professionals today. I've seen it personally: The belly of the anti-science beast.
- You should NOT start with a conclusion and try to fit your evidence to it. It's a bad way to learn things.
- If you do "fit" the data to match a conclusion, it will be found out. It won't last forever. You cannot stand on this.
- Crap science and conspiracy theory has real consequences. In this case children are dying from infectious disease. It may not always be that dramatic, but running off on crank conclusions can be harmful in many ways. It distracts from finding real causes, and wastes time and energy.
- People who are critical of your conclusions can make you stronger--if you have good data to stand on. If you have crap, you will be mocked. And you deserve it.
I just heard Wakefield on CNN in an interview with Anderson Cooper. He's claiming the journalist Deer is a "hit man" shill "bought to take me down" and is verbally HRing him for Deer's dogged attempts--and ultimately successful work--to set the record straight. Deer is the hero here. Luckily he has persisted despite the name-calling and threats by the forces of the anti-science cranks. It's not always welcomed. But it matters.
It's pretty clear that the reality-based wheels are largely off the orange bus these days. I almost didn't bother with this diary because I'm sure to be assaulted by people who will continue to HR me for challenging their preferred world view. But it was too good a learning opportunity to pass up.
This is a warning. Crap science will not stand. Don't stand on it yourself, and don't encourage others who do. It's ultimately bad for your case.
turnover has a take on the issue here: Vaccines, Autism, Wakefield: "An elaborate fraud."