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Secrets of the MMR scare

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BMJ response to emails

BMJ, the British Medical Journal, 7 February 2011

Fiona Godlee, editor in chief

Since we published the first of three articles by Brian Deer on the secrets of the MMR scare [1] and a linked editorial [2] on 5 January 2011, the BMJ has been the subject of an orchestrated campaign of emails. In response to questions raised in these emails, we make the following statement.

The BMJ stands by the article and the editorial. The article, which was subjected to peer review and editorial checking, was based on enquiries carried out over some seven years, involving, among other things, interviews with parents of children enrolled in Andrew Wakefield's research. Four such parents are quoted in the article. As made clear in the article, the core data on which the findings were based were evidenced, except in the case of one child, by the transcript of a General Medical Council fitness to practise hearing which sat between July 2007 and May 2010.

In many of the emails we have been sent, it is suggested that Andrew Wakefield did not have access to GP records and therefore could not be responsible for discrepancies between those records and what was published in the Lancet in February 1998. The case we presented against Andrew Wakefield that the 1998 Lancet paper was intended to mislead is not critically reliant on GP records. It is primarily based on Royal Free hospital records, including histories taken by clinicians, and letters and other documents received at the Royal Free from GPs and consultants.

We draw attention to the finding of the fitness to practise panel, on which we are entitled to rely, that "the project reported in the Lancet paper was established with the purpose to investigate a postulated new syndrome and yet the Lancet paper did not describe this fact at all. Because you [Wakefield] drafted and wrote the final version of the paper, and omitted correct information about the purpose of the study or the patient population, the panel is satisfied that your conduct was irresponsible and dishonest."

Contrary to other suggestions contained in the emails, we made no allegation of dishonesty against Andrew Wakefield's co-authors, or indeed against anybody else. As the GMC panel heard, it was Andrew Wakefield who wrote the Lancet paper, using data which he anonymised, with little oversight by other authors. We confirm that under the uniform requirements for manuscripts submitted to biomedical journals all authors should be in a position to speak to data, but the evidence is that in this case they were not.

We are aware of recent claims made by Andrew Wakefield that "new documents have come to light" purportedly confirming his claims in the Lancet. The material he cites was presented to the GMC panel two and a half years ago. Andrew Wakefield was last year erased from the medical register and he has chosen not to appeal that decision. As indicated, the very many charges proven against him include dishonesty in his research.

We are unaware of any peer reviewed paper replicating Andrew Wakefield's research or confirming his claims to have identified a new syndrome of regressive autism and inflammatory bowel disease associated with MMR vaccination. With respect to gastrointestinal issues, we draw attention to an authoritative consensus statement published last year by experienced specialists in this field [3] and particularly to statement 4: "The existence of a gastrointestinal disturbance specific to persons with ASDs (eg 'autistic enterocolitis') has not been established."

Fiona Godlee, Editor in Chief, BMJ

References

1. Deer B. How the case against the MMR vaccine was fixed. BMJ 2011; 342:c5347 doi: 10.1136/bmj.c5347

2. Godlee F, Smith J, Marcovitch H. Wakefield's article linking MMR vaccine and autism was fraudulent. BMJ 342:doi:10.1136/bmj.c7452

3. Buie T, Campbell DB, Fuchs GJ, et al. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus statement. Pediatrics 2010;125;S1-S18.

Competing interests: FG is editor in chief of the BMJ and responsible for all it contains.


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