Andrew Wakefield, the UK researcher who sparked unwarranted fears about the risks of the MMR vaccine, has been the subject of a two-and-a-half years ethics investigation by the General Medical Council (GMC). This afternoon the GMC announced their conclusion, ruling that Wakefield acted “dishonestly and irresponsibly” in his research and with “callous disregard” for the children that were the subject of his research.

Wakefield’s Story

In 1998 Wakefield and others published a story in the Lancet where they claimed to find an association between finding the measles virus in the GI tract of children with autism following the MMR vaccine. The study itself was small – only involving 12 children, and the conclusions were modest, not specifically suggesting a link between MMR and autism. But in subsequent press conferences Wakefield raised the alarm, saying, “Urgent further research is needed to determine whether MMR may give rise to this complication in a small number of people.”

The result was a significant drop in MMR compliance and a resurgence of measles cases, as this BBC chart demonstrates.

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Mark Twain would have made an excellent blogger. The man had a wit and eloquence difficult to match, and he was not afraid to use his skills. Fortunately, some of his writing can be repurposed for blogging – Letters of Note brings us a letter written by Twain in November of 1905 to the seller of a patent medicine that had just attempted to sell his wares to Twain.

The letter shows that Twain was savvy regarding the nature of patent medicines – they were a scam, born of the carnival barker tradition. Anyone unhindered by ethics could put whatever they wanted into a bottle, usually cutting it with some alcohol or other such substance, and then make whatever health claims they wished for their concoction. The FDA put an end to the patent medicine era, but now we are in the middle of a resurgence of patent medicine scams. The only thing that has changed is the name – now they are called “supplements”. The FDA has been weakened to allow anyone to put just about whatever they want in a bottle (as long as it is not already classified as a drug) and make whatever health claims they want for it (as long as they are the slightest bit clever in their wording – phrasing the claims as “structure/function” claims, rather than disease claims).

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This concept may bring new meaning to the phrase “Doc in a box” (used to refer to small walk-in clinics). Increasingly computers are infiltrating the practice of medicine – but to what extent have or will computers replace the cognitive work of trained health professionals? This is a concept I have been following with interest, but at the moment there is probably much less in the way of computer-assisted medicine than the the public imagines.

A news story today reminded me of the baby-steps that are being taken in the direction of AI (artificial intelligence) medicine. A new study shows that a computer program is as good or better at making a specific measurement (wear of the meniscus) on MRIs of the knee – but only when they are mild to moderately damaged, severe damage still requires a human eye.

This kind of thing is definitely the low-hanging-fruit for medical AI systems – interpreting digital images. It does not require making a diagnosis, weighing choices, or interpreting human input. It is simply using pattern recognition to measure one feature of an image.

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Mike Adams, editor of Natural News, is, in my opinion, a dangerous conspiracy-mongering crank. There is simply no way to be kind to his views and the nonsense he spreads on his website. His intellectual sloppiness is indistinguishable from dishonesty, as he peddles dubious cancer cures, pseudoscience such as homeopathy, and attacks vaccines and effective therapies for AIDS and other serious diseases.

His shtick is familiar – the body can heal itself of anything, “natural” (whatever that means) is the miracle cure that allows that to happen, and just about anything considered standard and scientific is an evil corporate conspiracy. Of course, anyone who criticizes his views or claims must be part of the conspiracy – a shill for the bogeyman – “big pharma”.

One common ploy of those who choose to make their living on the fringes of science and reason is to attack their critics – what I call a “preemptive strike” against those in the best position to know that what they claim is nonsense. This usually means scientists, and increasingly activist skeptics who endeavor to educate the public about science and pseudoscience. I think it is a testimony to the growing impact of the skeptical movement that we are increasingly being targeted by the likes of Mike Adams.

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I have never had a strong opinion on global climate change. The data is too esoteric and complex for a non-specialist, in my opinion, to have a firm grasp on it. So climate change is one area where I am content to defer to the consensus of expert opinion. I understand the basic arguments, and find them plausible and even compelling. I have listened to the dissidents, and do not find their arguments compelling. Maybe they have a point about the limitations of our ability to project climate into the future and understand all the consequences and remedies. Otherwise I find their argument severely wanting.

To be fair, “dissidents” comprise a fairly broad range of opinion in my experience, from mild skepticism to dedicated ideological denial. So they defy a single label or attempt to characterize their position, and any such attempt inevitably leads to angry responses from those who feel they have been treated unfairly. And further, there is ideology and extremism on the other side as well.

For me – probably like most people, I just want to understand the facts. I don’t really have any ideological stake in this debate. If there is anthropogenic global warming (which there seems to be) I think we should take reasonable steps to mitigate it. If there isn’t, then I don’t want us to waste our resources chasing our tail.

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My skeptical comrades down under have been kicking A and taking names. They demonstrate that skeptical activism can have concrete positive effects. Most recently they issued a complaint to the Therapeutic Goods Administration (the Australian equivalent of the FDA) about the claims being made on two homeopathy websites (“Homeopathy Plus!” and “www.d-n-h.org”). Specifically the cites claimed that homeopathic immunization (there is no such thing) was as effective as real immunization for the prevention of infectious diseases. They report:

Dr Ken Harvey, a lecturer at Latrobe University School of Public Health, who authored the complaint, objected to claims on the website that “homeopathic immunisation is effective against poliomyelitis, chicken pox, meningococcal disease, hepatitis (all types), Japanese encephalitis, HiB, influenza, measles, pnuemococcal disease, smallpox, typhoid, cholera, typhus whooping cough, rubella, mumps, diptheria, malaria, tetanus, yellow fever, dysentery and many other epidemic diseases”.

To support these claims the research of Isaac Golden was referenced, but the study referenced was in fact negative – without statistically significant results.

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As part of her series on autism quackery, Chicago Tribune writer Trine Tsouderos has written another eye-opening article – this one about the drug OSR#1 that is being given as a “supplement” to children with autism.

The story highlights what I have been writing for years – that the current supplement regulation in the US under the Dietary Supplement Health and Education Act (DSHEA) is an anti-consumer farse.

OSR#1 is a drug. It is a compound that was manufactured by a company for its pharmacological activity. They claim it was developed as an anti-oxidant, but the Tribune reports that the compound may have originally been developed as an industrial chelator – a compound that binds heavy metals to clean them from soil or industrial spills.

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I recently received the following e-mail:

Hi, I just started listening to your podcast and I’m really enjoying it. I noticed one of the things you discuss often is the anti-vaccination movement, and I’m grateful for that because I was able to use the information you guys were talking about to combat some stupidity. I’m a senior in high school and my health teacher is kind of nuts. She was talking about how it’s bad to eat fish when pregnant because of the mercury levels, but then decided to go off about how vaccines cause autism because of the mercury in them. I raised my hand and told her that the levels of mercury in vaccines were lower than in fish comparatively. She waffled a bit and said something about how some studies show different things and whatever. She then went on to talk about how she doesn’t want to vaccinate her kid and that the doctors just want to shove like 100 vaccines in her and get a kick back. I raised my hand again and told her that that’s not really a good idea because diseases like mumps are coming back because people aren’t vaccinating their kids. She misunderstood me I guess and then said something about how it is good to vaccinate in third world countries because of that and I said no, there have been outbreaks of mumps recently in the united states because some dumbasses decided not to vaccinate their stupid kids. She backtracked and said something about how it was good that I was playing the devil’s advocate, pretending like I was agreeing with her or something and completely ignored what I said. She then went on a rant about how corrupt the medical industry is and how doctors are just giving you pills to make money and the pills don’t really work and it’s all just the placebo effect, and then decided to talk about how awesome homeopathy is. I was so angry by then I was afraid if I opened my mouth an unintelligible stream of curses would just spew out. It just makes me so angry that someone like her is not only teaching, but teaching health of all things. She should not be telling people such bullshit, especially when she’s in such a powerful and influential position. She also earlier said some bullshit about how HIV could possibly not be real or something crazy because they’ve never seen the virus under a microscope and the symptoms are just other diseases. Is this like a new crazy thing that I’ve never heard of? She also loves chiropractors. Ugh.
I just really really really appreciate you guys and the sense that you guys make and in assuring me that there are sensible people out there in the world. Your rationality makes me feel warm and fuzzy on the inside and makes me not want to rip my hair out.

This is, unfortunately, not an isolated example. I frequently receive similar e-mails.

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In the 1990’s a small company started by William Clark began marketing a series of videos, the flagship of which was one called Baby Einstein. The title carries the promise that by watching the videos babies would gain a benefit to their intellectual development. The videos mostly consist of puppets and toys with classical music in the background. According to the company, they enjoyed 17 million dollars in sales, and then sold the company to Walt Disney.

Marketing hype rarely accords well with reality, and such is the case with Baby Einstein. There is a distinct lack of credible scientific evidence for any benefit from watching such videos. Further, two studies performed at the University of Washington appeared to show that, if anything, infants watching the videos had delayed language acquisition. One study was a phone survey of 1008 parents – here are the results:

Among infants (age 8 to 16 months), each hour per day of viewing baby DVDs/videos was associated with a 16.99-point decrement in CDI score in a fully adjusted model (95% confidence interval = -26.20 to -7.77). Among toddlers (age 17 to 24 months), there were no significant associations between any type of media exposure and CDI scores. Amount of parental viewing with the child was not significantly associated with CDI scores in either infants or toddlers.

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This is impressive. Really. Of course, it is not psychic – it is just a bit a clever code. It is also nothing new – it has been around in one form or another for years. You can buy these types of 20 questions game computers for personal use.

I have played with these before, and this one seems particularly effective.

Here’s the game – you think of a character and then the “genie” asks you a series of 20 questions. At the end it guesses your character. I played against it with Spock, Max Planck, Stanley Kubrick, Captain Jack Sparrow, and HAL 9000 – the Akinator guessed right every time. But then I was thinking of James Randi – Akinator guessed Don Vito, but then after 28 guesses came up with James Randi. The Akinator even got PZ Myers on the third try.

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