Friday, February 5, 2010

Consequences of mistaken science

The leading medical journal The Lancet has decided to withdraw a 1998 paper that linked autism to a vaccine commonly given to young children to prevent measles, mumps, and rubella. This had stirred up many interests, including of course in the drug industry that stood to be hit with many lawsuits, the medical profession for being casual about exposure to dangerous compounds, and parents devastated by serious autism in their children.

Autism had also been connected to heavy metal--ingestion, not rock concerts--years before when the latter was found at higher concentrations in the hair of autistic children than in non-autistic children. There seem to be many studies that connect autism, or autism severity, to heavy metal toxicity. And concerns included some vaccines that contain a mercury-containing preservative called Thimerosal. However the literature on the causes of autism is complex and extensive, with many attempts to show a genetic causal link as well, some of which seem convincing.

In any case, many studies, at great expense, have been done since the Lancet report, to confirm its serious conclusions, but few if any provided evidence for the link.

But society doesn't trust vested interests these days, for well-earned reasons, so parent advocacy groups sprung up to pursue the issue for some sort of redress. The government was suspected of covering up for vested interests and not coming clean with the public. The advocacy groups are not prone to give up on what they thought could explain the tragedies that have happened to their children.

A lot of cost and anguish!

But it now turns out that the original study had various unethical aspects including some outright misrepresentation of the data so The Lancet decided to withdraw the study, a very rare act of self-policing indeed. (Even if, according to the New York Times, this was done under threat of a soon-to-be-published demand by the British Medical Journal for The Lancet to retract the study.)

This may give a sigh of relief to infectious disease communities if it will lead to less suspicion of vaccines, and thus increased vaccination rates. It will be perhaps again devastating to parents of autistic children, who may feel they now have to start afresh to look for cause, and hence cure or prevention. But if the study was flawed, The Lancet did the right thing.

An important point here is credibility and honesty in science. It's related to issues like 'climategate' and to many issues of self-promotion, exaggeration, and vested interest that we've blogged about in regard to human genetics and evolutionary reconstructions. Science usually gets through these things, but at what cost? How many children, for example, have suffered serious disease because their parents were afraid to have them vaccinated? Apparently many, which in the UK included a number of hospitalizations and some deaths. Vaccination rates declined substantially in the UK after the 1998 paper appeared, allowing measles to make a come-back.

This is why we think even needless self-promotion in papers or the media, or in medical advertising is wrong and costly, if not downright dangerous. Excess claims are seized on by people desperate to understand the cause of serious disease, who yearn for explanations that can led to prevention or treatment. High integrity is hard to maintain in a society, including in science, that is founded on a belief system that says that competition is the be all and end all of personal success. Dissembling, failure to publish negative results, and the like all contribute to raise the risk of unfortunate abuses such as appear to have characterized the original Thimerosal study.

So, kids, roll up your sleeves. Here comes the needle!

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