Hard News by Russell Brown


Bad journalism, old stories

It is useful, if not exactly pleasant, to sometimes be reminded just how misleading "quality" journalism can be. Case in point: New health fears over big surge in autism, the lead story in The Observer yesterday. It reports "a study, as yet unpublished [that] shows that as many as one in 58 children may have some form" of autism.

It is, of course, pretty rash to report on the results of an unpublished study. But the paper's health correspondent, Denis Campbell, doesn't stop there:

Seven academics at Cambridge University, six of them from its renowned Autism Research Centre, undertook the research by studying children at local primary schools. Two of the academics, leaders in their field, privately believe that the surprisingly high figure may be linked to the use of the controversial MMR vaccine. That view is rejected by the rest of the team, including its leader, the renowned autism expert, Professor Simon Baron-Cohen.

The claim that the MMR vaccine causes autism emerged, notoriously, from the work of Professor Andrew Wakefield. Wakefield's practices were exposed and his theory debunked in part through newspaper investigations and a Channel 4 documentary by Brian Deer, who has a comprehensive website dedicated to the project. Wakefield sued Deer for libel, but ended up dropping the action and paying compensation to Deer.

Over the past two weeks, Wakefield's credibility has been shredded by expert testimony in a special omnibus hearing in a US court of claims by parents who believe that vaccines caused their children's autism. (Oddly, the claims hold that it is not the vaccine itself that caused autism -- Wakefield's theory -- but the presence of a form of mercury used as a preservative. MMR has never contained thimerosal.) .

Autism Diva has been providing exhaustive coverage of the proceedings. ScienceBlogs had a withering post too.

(Autism Diva also has plenty to say about the Observer's interview with Wakefield.)

Wakefield, who no longer works in Britain, has returned to face serious charges relating to his fitness to practice before the General Medical Council, relating to the 1998 research on which he based his claims. Campbell interviews him in a story appearing under the somewhat sympathetic headline I told the truth all along, says doctor at heart of autism row, which eventually goes on to say of the charges:

They include allegations that the three undertook research with the 12 children without proper approval from the Royal Free's ethics committee, failed to conduct their study along the lines they had sought ethical approval for, and did not treat their young patients in accordance with the ethical approval given. The trio are accused of carrying out procedures on children in the study, such as lumbar punctures and colonoscopies, that were not in the best interests of the health of some seriously ill young people.

According to the charge papers, the GMC will also hear claims that Wakefield and Walker-Smith 'acted dishonestly and irresponsibly' in failing to tell The Lancet how they had recruited the patients, and that the pair also acted irresponsibly when they gave one child 'a purportedly therapeutic substance for experimental reasons prior to obtaining information about the safety of the substance'.

Wakefield himself is further accused of being 'dishonest and misleading' when he obtained research funds from the Legal Aid Board, of ordering investigations to be carried out on some children even though he did not have the paediatric qualifications to do so, and that he took blood from children at a birthday party to use for research purposes after offering them money.

So let's return to Campbell's main story, in which he names the two "leading" academics on the study team as Dr Fiona Scott and Dr Carol Stott. Stott is a psychologist and is about as qualified to comment on diseases of the gut, immunology and PCR testing (all of which are relevant to the MMR claims) as I am. But there's more to it. Her name will be known to anyone who has looked at this saga. It was Stott who sent a string of abusive emails to Brian Deer, which led to a formal warning from the British Psychological Society. (Stott accused her colleagues of failing to support her in her battle with Deer because they were in thrall of drug companies.)

Campbell doesn't tell his readers all that. He also forgets to note that Stott is no longer employed as a junior researcher at Cambridge. She now works with the California-based clinic Thoughtful House, which is run by - did you see this coming? - Andrew Wakefield. As you might expect, Deer takes a dim view of what goes on there.

Until Deer started writing about it, Stott and Dr Fiona Scott shared a website, on which they touted their "substantial experience in medico-legal and educational-legal expert witness work" to parents who might have been minded to pursue legal action in the belief that the MMR vaccine had caused their children's autism.

It would appear that either or both of Stott and Scott are Campbell's source, and that the timing of the story around Wakefield's return to face the music before the GMC is no accident. NB: Dr Scott has accused The Observer of fabricating quotes, which I find unlikely, but it does perhaps suggest she isn't Campbell's source. Full text and link in the discussion for this post.

As I noted, the study on which the story is based has not been published. It may suggest that there is a rise in the incidence of autism spectrum conditions that cannot be explained by a broadening of diagnostic criteria. But the Autism Research Centre at Cambridge describes autism and Asperger Syndrome as "strongly heritable", and its director, Simon Baron-Cohen, explicitly rejected the vaccine theory when Campbell approached him:

Genetics, better recognition of the condition, environmental factors such as chemicals and children's exposure to hormones in the womb, especially testosterone, were more likely to be the cause, he commented. "As for MMR, at this point one can conclude that evidence does not support the idea that the MMR causes autism."

So why, when the centre is doing such fascinating and important research work across a range of disciplines, from psychology to genetics and neuroscience, has The Observer led with "new health fears" that are simply old allegations from an associate of a discredited researcher who is about to face serious ethics charges?

There will be some letters flying over this one.

PS: It is useful to understand what a test for autism actually is: it's a questionnaire - in this case, the Childhood Asperger Syndrome Test (CAST), which you can view here, along with other test material from the Autism Research Centre. The screening study mentioned in the Observer story is here.

PPS In unrelated news, a torrent among torrents has appeared on the interwebs: 139 episodes of Horizon, 1980-2007, totalling 78.1GB. Crikey.

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