Is
"Wakefield cluster" a chance finding or
a telltale clue to suspect research?
This page is
research from an investigation by Brian Deer for the UK's Channel 4 Television
and The Sunday Times of London into a campaign
linking the MMR children's
vaccine with autism. | Go to part I:
The Lancet scandal | Go to part II:
The Wakefield factor
One mystery in Andrew Wakefield's research concerns a
cluster of parents apparently blaming MMR.
Details of the first 30 children enrolled for the
research were published first in the Lancet (only 12 cases), then in
an abstract in the journal
Gut (the
first 12, plus the next 18). Of the first 12
cases, 8 apparently associated the MMR vaccine
with autism: two out of three. But in the next 18
cases, only 3 apparently made this association:
one out of six. How could this happen if the
children were all seen under the same protocol?
Scenario 1: even spacing
of MMR-autism reports as series continues
| <-------------------------
First 30 children
"consecutively" enrolled
------------------------> |
| <-----
Lancet 12 [from paper] ------> |
<-- Gut
extra 18 [1st hypothesised spread of 3
cases] --> |
Scenario 2: bunching
continues in line with reported Lancet cluster
| <-------------------------
First 30 children
"consecutively" enrolled
------------------------> |
| <-----
Lancet 12 [from paper] ------> |
<-- Gut
extra 18 [2nd hypothesised spread of 3
cases] --> |
These charts
give two illustrative scenarios. In maroon are
cases where parents apparently made the
MMR-autism association. For the Lancet 12,
they're distributed in accordance with the
details given in the paper. The Gut abstract
doesn't identify individual cases, so two
scenarios are presented: first in which the
continuation of the series into Gut involves an
evenly spaced reporting of an MMR-autism link;
second in which the bunching reported in the
Lancet paper continues. Either assumption, or
anything between, reveals an extraordinary
cluster at the start of the research - research
which began with a contract between Wakefield
and lawyers.
Both
scenarios assume that the data given in the Gut
abstract are accurate, and haven't been
toned-down - avoiding a transparently
unbelievable figure for the cumulative number of
parents alleged to be blaming MMR [reported in
the abstract as 11/30]. In an earlier version of the same Lancet
paper, based on the same 12 children, the parents
of 9 are reported to have blamed
MMR, which would make the above charts even more
extraordinary. Analysis suggests that it was
probably the ninth child in the series [in darker
grey above] whose status changed between
versions. Why the number of parents recorded in
medical records making an association with MMR
would go down hasn't yet been
explained. Subsequently, some parents of the
Lancet 12 children changed their minds, and the number alleged in court documents
to be damaged by MMR went up
from 8 [or 9,
depending on the version] to 11
[the other was a US citizen, flown in for tests].
Curiously,
the hospital's ethics committee ruled that only
children enrolled after December 18
1996
were to be included in the trial - a stipulation
accepted in writing by the investigators. But if
all the children admitted to the hospital in this
series prior to that date had been excluded [a
total of 7, possibly 8,
or even 9 in the earlier
version, who must inevitably be from the far left
of the diagrams], it's not clear how many
allegations of links with MMR would have been
left to publish in the Lancet and used to launch
the worldwide vaccine scare.
|