Fraud in Medical Research
Whilst thinking about homeopathy in the last post, the story of Andrew Wakefield was also in the news. If you type “Andrew Wakefield fraud” into Google, you get this story from Science-Based Medicine. Here is the first paragraph.
Pity poor Andrew Wakefield.
Actually, on second thought, Wakefield deserves no pity at all. After all, he is the man who almost single-handedly launched the scare over the MMR vaccine in Britain when he published his infamous Lancet paper in 1998 in which he claimed to have linked the MMR vaccine to regressive autism and inflammation of the colon, a study that was followed up four years later with a paper that claimed to have found the strain of attenuated measles virus in the MMR in the colons of autistic children by polymerase chain reaction (PCR). It would be one thing if these studies were sound science. If that were the case, then Wakefield’s work would have been very important and would have correctly cast doubt on the safety of the MMR. Unfortunately, they were not, and, indeed, most of the authors of the 1998 Lancet paper later withdrew their names from it.
Over the next decade, aided and abetted by useful idiots in the media, by British newspapers and other media that sensationalized the story, and the antivaccine movement, which hailed Wakefield as a hero, Wakefield managed to drive MMR vaccination rates in the U.K. below the level of herd immunity, from 93% to 75% (and as low as 50% in some parts of London). As a result Wakefield has been frequently sarcastically “thanked” for his leadership role in bringing the measles back to the U.K. to the point where, fourteen years after measles had been declared under control in the U.K., it was in 2008 declared endemic again.
David Gorski then goes on to show how badly Wakefield conducted his research. Read the whole article and the comments that follow it.
I am of an age, where it seemed in every class at school, there was a someone who had suffered the effects of polio. So to all of these antivaccine Fascists, I ask if they want to go back to those times. I also have friends and relatives, who were damaged by measles and/or mumps, who would have been saved by the MMR vaccine.
Wakefield’s badly conducted research and the fact that it was not properly checked before publishing in the Lancet has left a terrible legacy.
But there are two troubles with medical research!
Suppose, a doctor notices a link between symptom A and disease B, which is outside the normal scheme of things. If he publishes honestly, saying that this might be correct and can anybody shed light on what he has seen, many sufferers will accept what he says has gospel. Tabloid headlines will proclaim a new cure for cancer, when the doctor was just postulating something that might be useful. We see this all the time.
On the other hand, suppose this link goes totally against the established thinking. His research may well destroy the reputations of the great and good in the field. Would they allow his research to be published? Of course not. Horizon, made a programme about the messenger of the body, which turned out to be completely different to established thinking, some years ago. A lot of the programme was taken up discussing the problems of the researcher getting his ideas published.
To return to Wakefield. He definitely was helped by the bandwagon that developed after his research was published. But supposing he had been refused the publication, as his results were against established thinking. I’m with him there as I really hate censorship. But then his research was flawed and shouldn’t have been published.
Was it fraud?
Probably not in the established sense, but I feel Wakefield might have suffered from a fault very common in doctors. They have a theory and try and prove it. I am an engineer and if have a problem then I try and solve it. So if he was guilty of anything, I suspect it was not being honest with himself, his patients and his research. But we’ve all done that. I know I’ve made mistakes by using information in the wrong way. But my research hasn’t been nearly so important.
If fraud was just an isolated event in medical research, we should not be seriously worried, provided that research is properly reviewed and published.
But I have written a piece of software called Daisy.
One of the things it can do is to check the integrity of a set of numbers. A medical professor, showed me how to check a set of observations were consistent. All you do is look at the last digit and plot them as a simple histogram. If they are genuine numbers they will have one pattern and if they are some that have been made up, then they will have a different one.
The professor showed me some research where it was obvious that the numbers had been made to fit the theory.
Another isolated case?
No! A relative of someone I know was struck off for doing something similar.
So it goes on.
To avoid other cases like Wakefield, we need to make sure that all papers, and not just in the medical field, are thoroughly reviewed before publishing. This alone would make sure that researchers used the best methods and the most exacting standards. We should also have a system in place, that would not allow the suppressing of controversial research that would upset the status quo.