Most readers will be all too familiar with Dr Andrew Wakefield’s absurd, now fully retracted and discredited (the same goes for his medical license, thankfully) 1998 study suggesting a link between autism and vaccination. Dr Wakefield’s science was shoddy, and his conflicts of interest were both remarkable and undisclosed. In short, we feel confident describing this as low quality evidence with a high risk of bias if we have ever seen it. When a ‘researcher’ takes blood samples from guests at his child’s birthday party you know there’s trouble.
Unfortunately, Wakefield’s study was published by one of the highest-impact journals in medicine, and the story took off and became the cause celebre of Hollywood celebrities and pseudo-practitioners. Whereas measles had been all but eliminated and vaccination rates reassuringly high before this, there are now more and more reports of measles outbreaks due to reduced vaccine uptake.
Which is why we find it so disturbing that the New York Times recently ran an article entitled “An immune disorder at the root of autism” .The author, who is noted at the end of the article as having a forthcoming book on the topic (“An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases”), espouses baseless conspiracy theories loosely based on Wakefield’s discredited work, combining it with the “hygiene hypothesis” into a new form of propaganda. He even goes as far as to suggest that there is a “subset of autism–perhaps one third and very likely more—[that] looks like a type of inflammatory disease. And it begins in the womb.” What references, what science to back this up? It’s entirely unclear. Maybe you have to buy the book to find out.
As clinicians, researchers, and patients, we depend on methodologically sound studies to sort out what is effective and what is spurious or harmful. Then, conclusions need to be supported by the data, rather than baseless generalizations and conjectures. If the evidence isn’t there, or people (even unintentionally) mislead the public through overreaching the available evidence, researchers fail to fulfill our obligation to help people make the best choices possible. Effectively communicating evidence to the public for this purpose is a major part of evidence-based medicine.
That’s why we are privileged to have investigative journalist Brian Deer speaking at Evidence Live 2013. He was responsible for bringing forward the truth about Dr Wakefield’s gross scientific misconduct. His work exemplifies the importance of effectively communicating evidence to the people who need it most. If you’re interested in these issues, you should join us.