British Medical Journal, Lancet—Welcome to the Hall of Shame!
The foundation of medical knowledge is based on publications which are “peer-reviewed.” This is supposed to mean that several other experts in the field have read the scientific paper and then judged the information to be worthy of dissemination in a medical journal, allegedly for the greater good.
More than a decade ago, Lancet published a paper linking autism to MMR (measles, mumps, rubella) vaccines. The vaccination rate plummeted in Great Britain (and elsewhere), despite evidence to the contrary. This led to an increase in other serious childhood illnesses (most of which had been all but eradicated), and some of which resulted in death or serious injury. Dr. Wakefield, the researcher and author, who had been riding high on journalistic sensationalism at the time of publication, has now been found to have acted dishonestly and to have acted callously toward the children he treated. He may be stripped of his medical license.
The Lancet is as prestigious in GB as is our New England Journal of Medicine. So people take what they print very seriously. But the Lancet did not take their responsibilities very seriously. They did not retract the article despite overwhelming evidence that the author’s findings were bogus. They did not retract the article even though by 2004 scientific papers published elsewhere soundly debunked this theory and his work was in question.
Just this week, Lancet finally retracted the article. Removed it from their body of published literature. Much too little, much too late. How many children have been hurt? This reminds me of cutting through the down pillowcase and spreading all of the feathers and then asking someone to pick them up and make the pillow whole (yes, that famous Jewish tale that so adeptly describes the effects of Lashon Harah—evil speech/gossip).
The press is partly to blame for the spread of small pieces of the picture surrounding many medical and non-medical conditions. The sensationalist predictions about global climate change, also from GB, have come under scrutiny as another scientist seeks his 15 minutes of fame. And just in the last few weeks, the scientist who predicted that the Himalayan glaciers will recede by 2035 has admitted his data was not based on sound science but on a magazine article he read.
But back to autism, a subject obviously on my mind this week. West Hollywood, in Los Angeles county, California, has the highest rate of autism in the country. Your child is four times as likely to be affected if born there than anywhere else in the US. No longer can we say that autism is evenly spread geographically. Support for environmental factors is growing.
Will there be a mad rush to leave what may be a tainted environment? Or will the California sunshine prevail?
We don’t yet know the cause(s) of autism. And like so many other diseases and conditions, it is likely that many theories will be put forth and later found to be wrong or only partly true. That is the nature of scientific investigation when scientific inquiry is conducted properly and the dissemination of results done with great care.
The Lancet has failed us. All of us, not just the scientific/medical community. Not just the patients and their parents. Not just the society and the world. I hope that those who treasure freedom of the press also embrace the awesome responsibility of their trade. They must realize that they are here to serve us the truth, and not a slanted, sensational, sexy story which sells. Beware of what you read. Be wary of what you believe.
5 Comments
I agree that the media bear some culpability for today’s rampant anti-vaccinationism. However, it was a UK investigative reporter Brian Deer who exposed Wakefield’s wrongdoings. See Lancet summary
Are vaccines perfect? Not by a long shot. But they are safer than the diseases they prevent.
I sometimes write a post that collates blog responses, both positive and negative, to a given issue.
I’m keeping one now on responses to the Lancet retraction of the Wakefield’s paper.
I’ve added your post to the list.
The post is at
http://lizditz.typepad.com/i_speak_of_dreams/2010/02/on-the-lancets-retraction-of-wakefields-1998-paper-alleging-a-connection-between-the-mmr-vaccine-and.html
Judging by the number and range of posts applauding the Lancet retraction, the anti-vaccinationist movement may be on its way to being marginalized.
Thanks for the great comment. Hooray for one UK investigative journalist. The journal itself should not need one. They have known for a long time. Too long.
You are also right about vaccines not being perfect, and I will tell some professional tales next week about both sides. Sometimes the “herd” effect of the vaccine can hurt and individual, but in the case of autism, this does not seem to be the case.
I just discovered your blog and am glad I did. There is clearly a problem with the peer review process at Lancet and I look forward to reading more of what you have to say about peer review.
The anchor of a Canadian news program I listen to (As It Happens on CBC Radio) expressed surprise that the study had such an impact in the U.K. but conjectured that its effect in North America has been negligible. She must be hiding under a very enlightened rock. I live in a liberal university town in the United States and vaccine naysayers are a dime a dozen here. I do not have children, but if I did, I would hesitate to send them to school in one of the more affluent areas of town, where significant numbers of children do not receive vaccines. The parents who make this decision often have no understanding of how vaccines work and have not heard of the concept of herd immunity. Public education is vital, as it is in all matters of science.
I have a very dim view of peer review–in quality, in journals, in scientific paper presentation, society membership, choice of leaders in medical progress, etc. Why? Because too often it is not based on data, but politics. Having spent 10 years as head of the quality program at our Children’s Hospital, I realized that getting to the bottom of what could be made better was less important than whom you offended.
Until (and if) we ever get our medical community to self-police in a fair and just way, we will be faced with these embarrassing situations and continue to lose not only our credibility but also the hearts and minds of the best and the brightest who really are committed to advancing the greater good.
Another pet peeve is health literacy. But this is a hard one here, b/c we have a hot button issue (and understandably so) and we have so little good information.
Keep in touch.
Herd immunity in the NYT today — http://www.nytimes.com/2010/03/10/health/10flu.html