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.
|